Individual
JEFFREY THOMAS FISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
600 HIGHLAND AVE, PHARMACY MAIL CODE 1530, MADISON, WI 53792-0001
(608) 263-1290
Mailing address
600 HIGHLAND AVE, PHARMACY MAIL CODE 1530, MADISON, WI 53792-0001
(608) 263-1290
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
115358-7
MN
183500000X
Pharmacist
Primary
12372-040
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115358-7
PHARMACIST
MN
01
—
12372-040
PHARMACIST
WI
Enumeration date
11/20/2006
Last updated
07/08/2007
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