# ASSISTED LIVING PHARMACY SERVICE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285625681
- **Authorized official:** MR. DAVID MICHAEL HUIBREGTSE (MANAGING MEMBER)
- **Authorized official phone:** (414) 433-1700

## Contact information

- **Practice address:** W133N5138 CAMPBELL DR, MENOMONEE FALLS, WI 53051-7030
- **Practice address phone:** (414) 433-1700
- **Practice address fax:** (414) 433-1730
- **Mailing address:** W133N5138 CAMPBELL DR, MENOMONEE FALLS, WI 53051-7030
- **Mailing address phone:** (414) 433-1700
- **Mailing address fax:** (414) 433-1730

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | 8373042 | WI | Yes |

## Other

- **Enumeration date:** 11/03/2005
- **Last updated:** 03/07/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 33273200 | — | WI |
| 01 | — | 5127774 | NABP | — |