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Organization
HAYEKS SHOREWOOD PHARMACY INC
Active
Organization
HAYEKS SHOREWOOD PHARMACY INC
Active
Other names
HAYEKS SHOREWOOD PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM QUANDT RPH (OWNER)
(414) 332-8870
Entity
Organization
Contact information
Practice address
4001 N DOWNER AVE, MILWAUKEE, WI 53211-2127
(414) 332-8870
(414) 332-0188
Mailing address
4001 N DOWNER AVE, MILWAUKEE, WI 53211-2127
(414) 332-8870
(414) 332-0188
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
4184-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2113269
PK
—
05
—
33140700
—
WI
Enumeration date
08/10/2006
Last updated
04/25/2016
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