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Organization
BENEVOLENT CORPORATION CEDAR COMMUNITY
Active
Organization
BENEVOLENT CORPORATION CEDAR COMMUNITY
Active
Parent organization
BENEVOLENT CORPORATION CEDAR COMMUNITY
Other names
Cedar Lake Campus Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
BENEVOLENT CORPORATION CEDAR COMMUNITY
Authorized official
MR. JOSEPH T PICHLER (VICE PRESIDENT OF FINANCE)
(262) 306-4212
Entity
Organization
Contact information
Practice address
5595 COUNTY ROAD Z, WEST BEND, WI 53095-9224
(262) 306-2140
(262) 306-2141
Mailing address
5595 COUNTY ROAD Z, WEST BEND, WI 53095-9224
(262) 306-2140
(262) 306-2141
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
5115503
WI
3336L0003X
Long Term Care Pharmacy
5115503
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33027100
—
WI
Enumeration date
07/27/2005
Last updated
12/30/2020
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