Healthcare Provider Details

I. General information

NPI: 1558293191
Provider Name (Legal Business Name): PARHAM ABDI-KINSEY PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3148 DEMING WAY STE 160
MIDDLETON WI
53562-1486
US

IV. Provider business mailing address

3148 DEMING WAY STE 160
MIDDLETON WI
53562-1486
US

V. Phone/Fax

Practice location:
  • Phone: 608-410-1325
  • Fax: 608-410-1365
Mailing address:
  • Phone: 608-410-1325
  • Fax: 608-410-1365

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0207X
TaxonomyCompounded Sterile Preparations Pharmacist
License Number10176-42
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: