| NPI | 1891732244 |
|---|---|
| Doing Business As | ISAAC COGGS HERITAGE HEALTH CENTER |
| Entity Type | Organization |
| Authorized Contact | TITO L IZARD President CEO 414-267-2021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: WI 8664-42) |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: N/A) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2016-04-05 |