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Organization

ONCOLOGY ALLIANCE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DUDLEY BLANK RPH (DIR OF PHARM)
(414) 906-4400
Entity
Organization

Contact information

Practice address
1055 N MAYFAIR RD, WAUWATOSA, WI 53226-3436
(414) 479-8450
(414) 479-8670
Mailing address
1055 N MAYFAIR RD, WAUWATOSA, WI 53226-3436

Taxonomy

Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
21799020
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
32836000
WI
01
5129588
OTHER ID NUMBER-COMMERCIAL NUMBER
Enumeration date
05/26/2006
Last updated
11/21/2007
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