# FROEDTERT MEMORIAL LUTHERAN HOSPITAL, INC

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

## Provider details

- **NPI number:** 1316380785
- **Authorized official:** DALE DRIZD PHARMD (DIRECTOR PHARMACY OPERATIONS)
- **Authorized official phone:** (262) 532-5168

## Contact information

- **Practice address:** 1155 N MAYFAIR RD, WAUWATOSA, WI 53226-3462
- **Practice address phone:** (414) 955-5990
- **Mailing address:** 1155 N MAYFAIR RD, WAUWATOSA, WI 53226-3462
- **Mailing address phone:** (414) 955-5990

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0002X | Clinic Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 9196-42 | WI | Yes |
| 3336S0011X | Specialty Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 04/16/2013
- **Last updated:** 10/30/2017