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Organization
COMMUNITY CARE INC
Active
Organization
COMMUNITY CARE INC
Active
Other names
COMMUNITY CARE INC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH MUNSON (CEO)
(414) 231-4000
Entity
Organization
Contact information
Practice address
1555 S LAYTON BLVD, MILWAUKEE, WI 53215-1924
(414) 902-2397
(414) 649-9149
Mailing address
1555 S LAYTON BLVD, MILWAUKEE, WI 53215-1924
(414) 902-2397
(414) 649-9149
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
—
NULL
3336M0003X
Managed Care Organization Pharmacy
Primary
8638-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100036712
—
WI
01
—
2110889
PK
—
Enumeration date
08/18/2006
Last updated
10/24/2019
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