Organization
MIDTOWN PHARMACY SC
Active
Other names
Midtown Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
PAYAL SURANI (PRESIDENT)
(630) 624-3545
Entity
Organization
Contact information
Practice address
7235 W APPLETON AVE STE 101, MILWAUKEE, WI 53216-1932
(414) 269-0341
(414) 455-4509
Mailing address
7235 W APPLETON AVE, STE 101, MILWAUKEE, WI 53216-1932
(414) 269-0341
(414) 455-4509
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
9296-42
WI
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2150408
PK
—
Enumeration date
02/11/2015
Last updated
02/24/2015
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