Organization
FROEDTERT MEMORIAL LUTHERAN HOSPITAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN PERHACH (BUSINESS MANAGER)
(414) 805-6531
Entity
Organization
Contact information
Practice address
9200 W WISCONSIN AVE, STE 200C, MILWAUKEE, WI 53226-3522
(414) 805-0977
(414) 805-0980
Mailing address
N86W12999 NIGHTINGALE WAY, MENOMONEE FALLS, WI 53051-2102
(262) 532-5173
(262) 532-5105
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
8837-42
WI
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2111105
PK
—
05
—
36226900
—
WI
Enumeration date
05/07/2008
Last updated
01/30/2020
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