Organization
SHIKRET, INC
Active
Other names
Clinica Latina Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALEXANDER SHISTER (PRESIDENT)
(414) 333-2478
Entity
Organization
Contact information
Practice address
1238 S CESAR E CHAVEZ DR, MILWAUKEE, WI 53204-2267
(414) 333-2478
Mailing address
5335 W RIVER TRAIL RD, MEQUON, WI 53092-4876
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
9441-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9441-42
STATE LICENSE
WI
Enumeration date
01/31/2017
Last updated
02/23/2017
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