Healthcare Provider Details

I. General information

NPI: 1528333028
Provider Name (Legal Business Name): MONICA KOCA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2012
Last Update Date: 03/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 W WISCONSIN AVE FROEDTERT HOSP-INPATIENT PHARMACY
MILWAUKEE WI
53226-3522
US

IV. Provider business mailing address

9200 W WISCONSIN AVE FROEDTERT HOSP-INPATIENT PHARMACY
MILWAUKEE WI
53226-3522
US

V. Phone/Fax

Practice location:
  • Phone: 414-805-6845
  • Fax: 414-805-1010
Mailing address:
  • Phone: 414-805-6845
  • Fax: 414-805-1010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number11079-040
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: