Healthcare Provider Details

I. General information

NPI: 1699952192
Provider Name (Legal Business Name): MARILYN LEE KUHRT R.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARILYN LEE WININGER

II. Dates (important events)

Enumeration Date: 01/28/2008
Last Update Date: 10/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

916 KEITH PL
ONALASKA WI
54650-2678
US

IV. Provider business mailing address

16602 TEMPEST DR
FOLEY AL
36535-8147
US

V. Phone/Fax

Practice location:
  • Phone: 608-792-5212
  • Fax:
Mailing address:
  • Phone: 608-792-5212
  • Fax: 251-965-7790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberR9781-040
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number16391
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS46940
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: