# RELIABLE PHARMACY OF WISCONSIN LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Reliable Pharmacy of Wisconsin
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336653674
- **Authorized official:** CYNTHIA CERNAK (OWNER)
- **Authorized official phone:** (262) 565-6353

## Contact information

- **Practice address:** 10105 74TH ST STE 102, KENOSHA, WI 53142-7519
- **Practice address phone:** (262) 909-5685
- **Practice address fax:** (262) 925-8409
- **Mailing address:** 10105 74TH ST, SUITE 102, KENOSHA, WI 53142-7519
- **Mailing address phone:** (262) 909-5685
- **Mailing address fax:** (262) 925-8409

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 9488-42 | WI | Yes |

## Other

- **Enumeration date:** 11/22/2017
- **Last updated:** 07/19/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100073905 | — | WI |
| 01 | — | 2172877 | PK | — |