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Organization

FROEDTERT MEMORIAL LUTHERAN HOSPITAL, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DALE DRIZD PHARMD (DIRECTOR PHARMACY OPERATIONS)
(262) 532-5168
Entity
Organization

Contact information

Practice address
1155 N MAYFAIR RD, WAUWATOSA, WI 53226-3462
(414) 955-5990
Mailing address
1155 N MAYFAIR RD, WAUWATOSA, WI 53226-3462
(414) 955-5990

Taxonomy

Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
9196-42
WI
3336S0011X
Specialty Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2139864
PK
Enumeration date
04/16/2013
Last updated
10/30/2017
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