MEDICARE: ANN BJERKE 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
1	183500000X	Pharmacist	10490-040	WI

General Provider Information

NPI Number	:	1518244029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANN BJERKE RPH

Provider Business Mailing Address
First Line	:	2163 EMPIRE DR
Second Line	:
City	:	WAUKESHA
State	:	WI
Zip	:	53186-2637
Country	:	US
Telephone Number	:	262-549-0525
Fax Number	:

Provider Business Practice Location Address
First Line	:	221 E SUNSET DR
Second Line	:
City	:	WAUKESHA
State	:	WI
Zip	:	53189-7603
Country	:	US
Telephone Number	:	262-542-3981
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/11/2011
Last Update Date	:	11/11/2011

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