Organization
PHARMACEUTICAL SERVICES INC
Active
Other names
West Bend Assisted Living Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN F NIEBAUER RPH (OWNER)
(262) 677-1401
Entity
Organization
Contact information
Practice address
W209 N17321 INDUSTRIAL DR, JACKSON, WI 53037-9389
(262) 677-1401
(262) 677-9112
Mailing address
W209N17321 INDUSTRIAL DR, JACKSON, WI 53037-9389
(262) 677-1401
(262) 677-9112
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
8482042
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33243200
—
WI
Enumeration date
08/19/2006
Last updated
10/09/2007
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