Healthcare Provider Details
I. General information
NPI: 1609447168
Provider Name (Legal Business Name): CARLY ELIZABETH RIEGER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/06/2021
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10 TOWER DR
SUN PRAIRIE WI
53590-1239
US
IV. Provider business mailing address
10 TOWER DR
SUN PRAIRIE WI
53590-1239
US
V. Phone/Fax
- Phone: 608-825-3500
- Fax:
- Phone: 608-825-3500
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | 20858-40 |
| License Number State | WI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: