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NPI Code Detail

MEDICARE: RYAN LUEDER PHARM D

MEDICARE: RYAN LUEDER PHARM D
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
1183500000XPharmacistWI16136WI

General Provider Information

NPI Number : 1265719447
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN LUEDER PHARM D
Provider Business Mailing Address
First Line : 1585 ROLLING MEADOW DR
Second Line :
City : BROOKFIELD
State : WI
Zip : 53045-5479
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6707 W HAMPTON AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53218-4833
Country : US
Telephone Number : 414-536-1179
Fax Number : 414-536-1463
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2011
Last Update Date : 11/15/2011

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Directions to “ RYAN LUEDER PHARM D” Practice Location

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