| NPI | 1841627015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN PERHACH Business Manager 262-532-5163 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy, Clinic Pharmacy (Licence: WI 9228-42) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2013-10-03 |
| Last Update Date | 2019-10-18 |