# HEALTH CENTER PHARMACY OF MENOMONEE FALLS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** HEALTH CENTER PHARMACY-WEST
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992704159
- **Authorized official:** THOMAS HOFBAUER RPH (MANAGER)
- **Authorized official phone:** (262) 574-7869

## Contact information

- **Practice address:** N14W23900 STONE RIDGE DR, WAUKESHA, WI 53188-1135
- **Practice address phone:** (262) 574-7869
- **Practice address fax:** (262) 574-8019
- **Mailing address:** N14W23900 STONE RIDGE DR, WAUKESHA, WI 53188-1135
- **Mailing address phone:** (262) 574-7869
- **Mailing address fax:** (262) 574-8019

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0002X | Clinic Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 6734042 | WI | Yes |

## Other

- **Enumeration date:** 07/19/2005
- **Last updated:** 03/16/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 33196600 | — | WI |
| 01 | — | 5118105 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |