# FROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** FROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS
- **Other names:** Potawatomi Workplace Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1801373378
- **Legal business name:** FROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS
- **Authorized official:** RANDALL NEWMAN (VP FINANCE)
- **Authorized official phone:** (414) 777-7963

## Contact information

- **Practice address:** 1721 W CANAL ST, MILWAUKEE, WI 53233
- **Practice address phone:** (414) 454-8480
- **Mailing address:** W129N7055 NORTHFIELD DR, MENOMONEE FALLS, WI 53051-0538
- **Mailing address phone:** (262) 253-5102

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332900000X | Non-Pharmacy Dispensing Site | — | NULL | Yes |

## Other

- **Enumeration date:** 07/26/2018
- **Last updated:** 07/26/2018