Healthcare Provider Details

I. General information

NPI: 1013844836
Provider Name (Legal Business Name): LEI AN RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8434 W SILVER SPRING DR
MILWAUKEE WI
53225-2824
US

IV. Provider business mailing address

8434 W SILVER SPRING DR
MILWAUKEE WI
53225-2824
US

V. Phone/Fax

Practice location:
  • Phone: 414-509-2222
  • Fax: 414-509-2221
Mailing address:
  • Phone: 414-509-2222
  • Fax: 414-509-2221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number20349-40
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: