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NPI Code Detail

MEDICARE: ELIZABETH NOLDER PHARMACIST

MEDICARE: ELIZABETH NOLDER PHARMACIST
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
1183500000XPharmacist9688WI

General Provider Information

NPI Number : 1700868825
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH NOLDER PHARMACIST
Provider Business Mailing Address
First Line : 3023 S 84TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53227-3703
Country : US
Telephone Number : 414-607-4101
Fax Number : 414-607-4502
Provider Business Practice Location Address
First Line : 7300 W DEAN RD
Second Line :
City : MILWAUKEE
State : WI
Zip : 53223-2637
Country : US
Telephone Number : 414-371-7380
Fax Number : 414-371-7525
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2005
Last Update Date : 07/08/2007

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