Healthcare Provider Details

I. General information

NPI: 1801893805
Provider Name (Legal Business Name): KAREN JEAN KUCHAR RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2005
Last Update Date: 08/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

W180N8085 TOWN HALL RD
MENOMONEE FALLS WI
53051-3518
US

IV. Provider business mailing address

W150N5304 BADGER DR
MENOMONEE FALLS WI
53051-6773
US

V. Phone/Fax

Practice location:
  • Phone: 262-257-3070
  • Fax:
Mailing address:
  • Phone: 262-790-9946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number11688
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: