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Organization
LIFE TREE PHARMACY LLC
Active
Organization
LIFE TREE PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN ENERIAKPOZI EZEKIEL (PHJARMACIST-IN-CHARGE)
(414) 698-5044
Entity
Organization
Contact information
Practice address
8329-5 W APPLETON AVE, MILWAUKEE, WI 53218
(414) 698-5044
Mailing address
5450 W GREEN TREE RD, MILWAUKEE, WI 53223-5289
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
9459-42
WI
Other
Enumeration date
05/10/2017
Last updated
05/10/2017
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