Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
METHODIST MANOR HEALTH CENTER, INC.
Active
Organization
METHODIST MANOR HEALTH CENTER, INC.
Active
Other names
Manor Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES ENLUND (PRESIDENT & CEO)
(414) 607-4100
Entity
Organization
Contact information
Practice address
8615 W BELOIT RD, WEST ALLIS, WI 53227-3711
(414) 607-2165
(414) 607-4507
Mailing address
3023 S 84TH ST, WEST ALLIS, WI 53227-3703
(414) 607-4100
(414) 607-4502
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
6309
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33028500
—
WI
01
—
5116187
NCPDP NUMBER
WI
01
—
6309
STATE LICENSE NUMBER
WI
Enumeration date
03/03/2006
Last updated
03/07/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up