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NPI Code Detail

MEDICARE: CHRIS L CORICA RPH

MEDICARE: CHRIS L CORICA 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
1183500000XPharmacist12291-40WI

General Provider Information

NPI Number : 1467739797
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRIS L CORICA RPH
Provider Business Mailing Address
First Line : 7600 W CAPITOL DR
Second Line :
City : MILWAUKEE
State : WI
Zip : 53222-2055
Country : US
Telephone Number : 414-464-4601
Fax Number : 414-464-5438
Provider Business Practice Location Address
First Line : 7600 W CAPITOL DR
Second Line :
City : MILWAUKEE
State : WI
Zip : 53222-2055
Country : US
Telephone Number : 414-464-4601
Fax Number : 414-464-5438
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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