Healthcare Provider Details

I. General information

NPI: 1457425092
Provider Name (Legal Business Name): LAABS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 N 27TH ST
MILWAUKEE WI
53208-3537
US

IV. Provider business mailing address

911 N 27TH ST
MILWAUKEE WI
53208-3537
US

V. Phone/Fax

Practice location:
  • Phone: 414-342-0145
  • Fax:
Mailing address:
  • Phone: 414-342-0145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number83-045
License Number StateWI

VIII. Authorized Official

Name: MR. THOMAS E VOLKMANN
Title or Position: PRESIDENT
Credential:
Phone: 414-342-0145