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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, OUTPATIENT PHARMACY OPERA)
(262) 532-5168
Entity
Organization
Contact information
Practice address
W180N8000 TOWN HALL RD, MENOMONEE FALLS, WI 53051-4002
(262) 532-3066
(262) 532-5105
Mailing address
N86W12999 NIGHTINGALE WAY, MENOMONEE FALLS, WI 53051-2102
(262) 535-5173
(262) 532-5105
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0002X
Clinic Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
9162-42
WI
3336C0004X
Compounding Pharmacy
—
NULL
3336S0011X
Specialty Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2137028
PK
—
Enumeration date
10/22/2012
Last updated
04/20/2018
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