Organization
COMMUNITY CARE INC
Active
Other names
COMMUNITY CARE INC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH MUNSON (CEO)
(414) 231-4000
Entity
Organization
Contact information
Practice address
1555 S LAYTON BLVD, MILWAUKEE, WI 53215-1924
(414) 902-2397
(414) 649-9149
Mailing address
1555 S LAYTON BLVD, MILWAUKEE, WI 53215-1924
(414) 902-2397
(414) 649-9149
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
—
—
3336M0003X
Managed Care Organization Pharmacy
Primary
8638-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100036712
—
WI
01
—
2110889
PK
—
Enumeration date
08/18/2006
Last updated
10/24/2019
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