Organization
CEDARBURG PRESCRIPTION CENTER INC
Active
Other names
North Shore Pharmacy, YE OLDE PHARMACY AND WELLNESS CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE BEYER (OWNER)
(414) 232-4103
Entity
Organization
Contact information
Practice address
N54W6135 MILL ST, STE 300, CEDARBURG, WI 53012-2021
(262) 375-0010
(262) 375-0080
Mailing address
N54W6135 MILL ST, STE 300, CEDARBURG, WI 53012-2021
(262) 375-0010
(262) 375-0080
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
054.018973
IL
3336C0003X
Community/Retail Pharmacy
22-44771
KS
3336C0003X
Community/Retail Pharmacy
7808-42
WI
3336C0003X
Community/Retail Pharmacy
Primary
PH29535
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2108915
PK
—
05
—
33233800
—
WI
Enumeration date
09/06/2006
Last updated
03/20/2023
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