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General NPI Number Information
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NPI Number | 1134142839
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Entity Type | Organization
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Legal Business Name | MILWAUKEE CENTER FOR INDEPENDENCE INC
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 05/08/2024
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Provider Practice Location Address
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Address Line | 2020 W. WELLS STREET
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City | MILWAUKEE
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State | WI
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Zip | 53233-2720
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Country | US
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Telephone | 414-476-8602
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Fax | 414-615-0626
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Provider Business Mailing Address
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Address Line | 2020 W. WELLS STREET
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City | MILWAUKEE
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State | WI
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Zip | 53233-2720
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Country | US
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Telephone | 414-476-8602
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Fax | 414-615-0626
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | ANDREW MAULE
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Credential |
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Telephone | 608-692-9495
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 9246-42
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License Number State | WI
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