Organization
HEALTH CENTER PHARMACY OF MENOMONEE FALLS
Active
Other names
HEALTH CENTER PHARMACY-WEST
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS HOFBAUER RPH (MANAGER)
(262) 574-7869
Entity
Organization
Contact information
Practice address
N14W23900 STONE RIDGE DR, WAUKESHA, WI 53188-1135
(262) 574-7869
(262) 574-8019
Mailing address
N14W23900 STONE RIDGE DR, WAUKESHA, WI 53188-1135
(262) 574-7869
(262) 574-8019
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
6734042
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33196600
—
WI
01
—
5118105
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/19/2005
Last updated
03/16/2010
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