Healthcare Provider Details

I. General information

NPI: 1962755454
Provider Name (Legal Business Name): ANDREW R HOCHRADEL PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2012
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7080 N PORT WASHINGTON RD
GLENDALE WI
53217-3879
US

IV. Provider business mailing address

10101 W GREENFIELD AVE STE 130
WEST ALLIS WI
53214-3953
US

V. Phone/Fax

Practice location:
  • Phone: 414-351-4009
  • Fax:
Mailing address:
  • Phone: 414-533-6600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17512-40
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: