Healthcare Provider Details

I. General information

NPI: 1376933986
Provider Name (Legal Business Name): AMY TISCHER PHARMACIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2015
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

W289N3452 LOST CREEK CT
PEWAUKEE WI
53072-3302
US

IV. Provider business mailing address

W289N3452 LOST CREEK CT
PEWAUKEE WI
53072-3302
US

V. Phone/Fax

Practice location:
  • Phone: 262-424-9943
  • Fax:
Mailing address:
  • Phone: 262-424-9943
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number16615-40
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: