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Organization

SURETY PRO PHARMACY LLC

Active
Other names
Surety Pro Pharmacy LLC
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GARY P. OLSZEWSKI RPH (VICE PRESIDENT PHARMACY)
(414) 433-0188
Entity
Organization

Contact information

Practice address
9200 W LAYTON AVE, GREENFIELD, WI 53228-3348
(414) 433-0188
(414) 433-0292
Mailing address
PO BOX 9830, SALT LAKE CITY, UT 84109-9830
(877) 540-4748
(801) 716-4872

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336L0003X
Long Term Care Pharmacy
Primary
9083-42
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2131230
PK
Enumeration date
08/15/2011
Last updated
10/24/2016
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