Organization
FROEDTERT MEMORIAL LUTHERAN HOSPITAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DALE DRIZD PHARMD (DIRECTOR, OUTPATIENT PHARMACY OPERA)
(262) 532-5168
Entity
Organization
Contact information
Practice address
W180N8000 TOWN HALL RD, MENOMONEE FALLS, WI 53051-4002
(262) 532-3066
(262) 532-5105
Mailing address
N86W12999 NIGHTINGALE WAY, MENOMONEE FALLS, WI 53051-2102
(262) 535-5173
(262) 532-5105
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
9162-42
WI
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2137028
PK
—
Enumeration date
10/22/2012
Last updated
04/20/2018
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