Organization
COMMUNITY MEMORIAL HOSPITAL OF MENOMONEE FALLS INC
Active
Other names
F & MCW Drexel Town Square Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN PERHACH (BUSINESS MANAGER)
(262) 532-5163
Entity
Organization
Contact information
Practice address
7901 S 6TH ST, OAK CREEK, WI 53154-2010
(414) 346-8050
(262) 532-5105
Mailing address
N86W12999 NIGHTINGALE WAY, MENOMONEE FALLS, WI 53051-2102
(262) 532-5163
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
9462-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811416639
—
WI
01
—
2171439
PK
—
Enumeration date
09/13/2017
Last updated
07/19/2018
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