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Organization
FROEDTERT MEMORIAL LUTHERAN HOSPITAL, INC
Active
Organization
FROEDTERT MEMORIAL LUTHERAN HOSPITAL, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DALE DRIZD PHARMD (DIRECTOR PHARMACY OPERATIONS)
(262) 532-5168
Entity
Organization
Contact information
Practice address
1155 N MAYFAIR RD, WAUWATOSA, WI 53226-3462
(414) 955-5990
Mailing address
1155 N MAYFAIR RD, WAUWATOSA, WI 53226-3462
(414) 955-5990
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
9196-42
WI
3336S0011X
Specialty Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2139864
PK
—
Enumeration date
04/16/2013
Last updated
10/30/2017
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