Organization
FHHP SUSSEX LLC
Active
Other names
FHHP Sussex
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA BREITENSTEIN (CONTRACTING SPECIALIST)
(920) 992-6800
Entity
Organization
Contact information
Practice address
N65W24838 MAIN ST, SUSSEX, WI 53089-2670
(262) 820-0200
(262) 820-0243
Mailing address
333 LOWVILLE RD, RIO, WI 53960-9437
(920) 992-6800
(920) 992-6801
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
9207-42
WI
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2140931
PK
—
Enumeration date
06/25/2013
Last updated
07/02/2014
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