NPI | 1881783777 |
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Doing Business As | FROEDTERT OUTPATIENT WEST PHARMACY |
Entity Type | Organization |
Authorized Contact | JEFFERY R VAN DE KREEKE Sr. Vice President Finance 414-777-0968 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WI 7501-042) |
Additional Taxonomies | 3336S0011X Pharmacy, Specialty Pharmacy |
3336C0002X Pharmacy, Clinic Pharmacy | |
332B00000X Durable Medical Equipment & Medical Supplies | |
Enumeration Date | 2006-10-11 |
Last Update Date | 2009-05-06 |