| NPI | 1992704159 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS HOFBAUER Manager 262-574-7869 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: WI 6734042) |
| Additional Taxonomies | 3336C0002X Pharmacy Clinic Pharmacy |
| 333600000X Pharmacy | |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2010-03-16 |