Individual
MR. RANDY SOUKUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BS RPH
Contact information
Practice address
5000 W NATIONAL AVE, MILWAUKEE, WI 53295-0001
(414) 384-2000
(414) 389-4276
Mailing address
4550 S HEARTH RIDGE DR, NEW BERLIN, WI 53151-9251
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10614-040
WI
Other
Enumeration date
07/19/2006
Last updated
07/08/2007
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