Healthcare Provider Details

I. General information

NPI: 1881826436
Provider Name (Legal Business Name): BRYAN S MCGILL RPH, PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2009
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 W NATIONAL AVE
MILWAUKEE WI
53295-0001
US

IV. Provider business mailing address

4073 N PROSPECT AVE
SHOREWOOD WI
53211-2121
US

V. Phone/Fax

Practice location:
  • Phone: 414-384-2000
  • Fax:
Mailing address:
  • Phone: 608-239-5241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number14214-40
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: