Healthcare Provider Details

I. General information

NPI: 1275930059
Provider Name (Legal Business Name): BORIS REMPEL PHARMD.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/22/2014
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1123 N VAN BUREN ST
MILWAUKEE WI
53202-3269
US

IV. Provider business mailing address

1758 LUDINGTON AVE
WAUWATOSA WI
53226-2837
US

V. Phone/Fax

Practice location:
  • Phone: 414-347-9219
  • Fax:
Mailing address:
  • Phone: 414-704-1592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number17691-40
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: