# MORELAND PLAZA PHARMACY, INC

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

## Provider details

- **NPI number:** 1619071628
- **Authorized official:** MR. SCOTT E HOFF RPH (PHARMACIST)
- **Authorized official phone:** (262) 542-4488

## Contact information

- **Practice address:** 827 W MORELAND BLVD, WAUKESHA, WI 53188-2963
- **Practice address phone:** (262) 542-4488
- **Practice address fax:** (262) 650-4040
- **Mailing address:** 827 W MORELAND BLVD, WAUKESHA, WI 53188-2963
- **Mailing address phone:** (262) 542-4488
- **Mailing address fax:** (262) 650-4040

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 4015-042 | WI | Yes |

## Other

- **Enumeration date:** 09/11/2006
- **Last updated:** 06/19/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 33195300 | — | WI |