# PRUNELLA PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Prunella Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831073022
- **Authorized official:** FATMA SAAD RPH (PHARMACY MANAGER)
- **Authorized official phone:** (262) 420-9525

## Contact information

- **Practice address:** 17135 W CAPITOL DR, STE 110, BROOKFIELD, WI 53005
- **Practice address phone:** (262) 420-9525
- **Practice address fax:** (414) 296-8456
- **Mailing address:** 17135 W CAPITOL DRIVE, SUITE 110, BROOKFIELD, WI 53005
- **Mailing address phone:** (262) 777-6911
- **Mailing address fax:** (262) 777-6910

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 08/01/2025
- **Last updated:** 11/25/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 10157-42 | STATE PHARMACY LICENSE | WI |