Organization
GLENDALE PRESCRIPTION CENTER INC
Active
Other names
MD CUSTOM RX
Organization subpart
No
Provider details
NPI number
Authorized official
MONICA MARIE ZATARSKI (OWNER PRESIDENT)
(414) 967-9248
Entity
Organization
Contact information
Practice address
5322 N PORT WASHINGTON RD, GLENDALE, WI 53217-4913
(414) 967-9248
(414) 967-9548
Mailing address
5322 N PORT WASHINGTON RD, GLENDALE, WI 53217-4913
Taxonomy
Speciality
Code
Description
License number
State
3336S0011X
Specialty Pharmacy
Primary
8506042
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5128738
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
06/13/2006
Last updated
08/22/2020
About Stedi
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