Organization
NEW BERLIN PHARMACY INC
Active
Other names
New Berlin Pharmacy Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
JASON KILVINGER (OWNER)
(414) 881-2766
Entity
Organization
Contact information
Practice address
14105 W GREENFIELD AVE, NEW BERLIN, WI 53151-1640
(262) 782-0460
(262) 782-4124
Mailing address
14105 W GREENFIELD AVE, NEW BERLIN, WI 53151-1640
(262) 782-0460
(262) 782-4124
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
8899042
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5131343
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/08/2009
Last updated
05/10/2012
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