# FROEDTERT MEMORIAL LUTHERAN HOSPITAL, INC.

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

## Provider details

- **NPI number:** 1457604928
- **Authorized official:** DALE DRIZD PHARMD (DIRECTOR, OUTPATIENT PHARMACY OPERA)
- **Authorized official phone:** (262) 532-5168

## Contact information

- **Practice address:** W180N8000 TOWN HALL RD, MENOMONEE FALLS, WI 53051-4002
- **Practice address phone:** (262) 532-3066
- **Practice address fax:** (262) 532-5105
- **Mailing address:** N86W12999 NIGHTINGALE WAY, MENOMONEE FALLS, WI 53051-2102
- **Mailing address phone:** (262) 535-5173
- **Mailing address fax:** (262) 532-5105

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0002X | Clinic Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 9162-42 | WI | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |
| 3336S0011X | Specialty Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 10/22/2012
- **Last updated:** 04/20/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2137028 | PK | — |