Organization
UNIVERSITY OF WISCONSIN HOSPITALS AND CLINICS AUTHORITY
Active
Parent organization
UNIVERSITY OF WISCONSIN HOSPITALS AND CLINICS AUTHORITY
Other names
Northeast Family Practice Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
UNIVERSITY OF WISCONSIN HOSPITALS AND CLINICS AUTHORITY
Authorized official
ALAN KAPLAN MD (CEO)
(608) 263-7013
Entity
Organization
Contact information
Practice address
3209 DRYDEN DR, MADISON, WI 53704-3015
(608) 241-9638
(608) 241-0857
Mailing address
600 HIGHLAND AVE, PHARMACY F6/133, MADISON, WI 53792-1530
(608) 263-1290
(608) 263-9424
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
8035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0641600006
PTAN (PHARMACY MEDICARE PROVIDER NUMBER)
—
05
—
33212000
—
WI
01
—
5121443
NCPDP NO
WI
01
—
8035
PHARMACY LICENSE NO
WI
Enumeration date
09/28/2006
Last updated
03/07/2023
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