Organization
MEDICAP PHARMACY SC
Active
Other names
Midtown Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
VIPUL PATEL (PRESIDENT)
(414) 299-3828
Entity
Organization
Contact information
Practice address
7733 W BURLEIGH ST, MILWAUKEE, WI 53222-5003
(414) 299-3828
(414) 299-3836
Mailing address
7733 W BURLEIGH ST, MILWAUKEE, WI 53222-5003
(414) 299-3828
(414) 299-3836
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
9357-42
WI
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100051081
—
WI
01
—
2155911
PK
—
Enumeration date
12/10/2015
Last updated
04/05/2017
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