Organization
FROEDTERT MEMORIAL LUTHERAN HOSPITAL, INC.
Active
Other names
Center for Advanced Care Pharmacy
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, CFAC PHARMACY, MILWAUKEE, WI 53226-3522
(414) 805-1295
(414) 805-1299
Mailing address
N86W12999 NIGHTINGALE WAY, MENOMONEE FALLS, WI 53051-2102
(262) 532-5173
(262) 532-5105
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
9309-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1356722045
—
WI
01
—
2152531
PK
—
Enumeration date
06/18/2015
Last updated
11/21/2017
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