Organization
SOUTHWEST PHARMACY INC
Active
Other names
THE PHARMACY SHOPPE
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES HOFBAUER (OWNER)
(414) 384-1660
Entity
Organization
Contact information
Practice address
3201 S 16TH ST STE 1030, MILWAUKEE, WI 53215-4532
(414) 384-1660
(414) 384-1753
Mailing address
3201 S 16TH ST STE 1030, MILWAUKEE, WI 53215-4532
(414) 384-1660
(414) 384-1753
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
6817042
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33154000
—
WI
01
—
5110868
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/16/2006
Last updated
05/12/2010
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