Organization
FROEDTERT MEMORIAL LUTHERAN HOSPITAL, INC.
Active
Other names
Froedtert Outpatient East Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY R VAN DE KREEKE (SR. VICE PRESIDENT - FINANCE)
(414) 777-0968
Entity
Organization
Contact information
Practice address
9200 W WISCONSIN AVE, SUITE 100E, MILWAUKEE, WI 53226-3522
(414) 805-6501
(414) 805-6513
Mailing address
9200 W WISCONSIN AVE, SUITE 100E, MILWAUKEE, WI 53226-3522
(414) 805-6501
(414) 805-6513
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
7516-042
WI
3336S0011X
Specialty Pharmacy
—
—
Other
Enumeration date
10/18/2006
Last updated
05/06/2009
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