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Individual
DR. KENNETH JACOB GERHARDT JR.
Active
Individual
DR. KENNETH JACOB GERHARDT JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
361924025
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1481650
NATIONAL ASSOCIATION OF BOARD OF PHARMACIS
WI
01
—
21327-40
PHARMACY LICENSE
WI
Enumeration date
08/12/2022
Last updated
08/12/2022
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