Organization
AURORA SINAI MEDICAL
Active
Other names
JOHNSTON PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI SOERENS (BILLING MANAGER)
(920) 803-3260
Entity
Organization
Contact information
Practice address
1230 W GRANT ST, MILWAUKEE, WI 53215-2732
(414) 672-5147
(414) 384-5578
Mailing address
1230 W GRANT ST, MILWAUKEE, WI 53215-2732
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
6992
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32955300
—
WI
01
—
5118282
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/11/2006
Last updated
08/22/2020
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