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Organization
CUDAHY CLINIC PHCY INC
Active
Organization
CUDAHY CLINIC PHCY INC
Active
Other names
CUDAHY CLINIC SERV U PHCY
Organization subpart
No
Provider details
NPI number
Authorized official
PETER TOPOLOVICH RPH (OWNER)
(414) 769-6150
Entity
Organization
Contact information
Practice address
3533 E RAMSEY AVE, CUDAHY, WI 53110-3009
(414) 769-6150
(414) 769-1551
Mailing address
3533 E RAMSEY AVE, CUDAHY, WI 53110-3009
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
6574042
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33046100
—
WI
01
—
5117064
OTHER ID NUMBER
—
Enumeration date
08/10/2006
Last updated
10/16/2007
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