Healthcare Provider Details

I. General information

NPI: 1073117867
Provider Name (Legal Business Name): PAUL JOSEPH HOFFMANN RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2020
Last Update Date: 11/23/2020
Certification Date: 11/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1821 N 16TH ST
MILWAUKEE WI
53205-1626
US

IV. Provider business mailing address

1106 CRESTVIEW DR
PORT WASHINGTON WI
53074-1347
US

V. Phone/Fax

Practice location:
  • Phone: 414-977-0001
  • Fax: 414-892-5783
Mailing address:
  • Phone: 414-614-4123
  • Fax: 414-892-5783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number10635
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: