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NPI Code Detail

MEDICARE: MR. MICHAEL JOHN JONAS RPH

MEDICARE: MR. MICHAEL JOHN JONAS RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist9442WI

General Provider Information

NPI Number : 1164706842
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MICHAEL JOHN JONAS RPH
Provider Business Mailing Address
First Line : 4730 S 27TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53221-2602
Country : US
Telephone Number : 414-817-0647
Fax Number : 414-817-0724
Provider Business Practice Location Address
First Line : 4730 S 27TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53221-2602
Country : US
Telephone Number : 414-817-0647
Fax Number : 414-817-0724
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2011
Last Update Date : 05/24/2026

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