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Organization
FROEDTERT MEMORIAL LUTHERAN HOSPITAL, INC.
Active
Organization
FROEDTERT MEMORIAL LUTHERAN HOSPITAL, INC.
Active
Other names
Center for Advanced Care Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN PERHACH (BUSINESS MANAGER)
(414) 805-6531
Entity
Organization
Contact information
Practice address
9200 W WISCONSIN AVE, CFAC PHARMACY, MILWAUKEE, WI 53226-3522
(414) 805-1295
(414) 805-1299
Mailing address
N86W12999 NIGHTINGALE WAY, MENOMONEE FALLS, WI 53051-2102
(262) 532-5173
(262) 532-5105
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0002X
Clinic Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
9309-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1356722045
—
WI
01
—
2152531
PK
—
Enumeration date
06/18/2015
Last updated
11/21/2017
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