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General NPI Number Information
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NPI Number | 1164592150
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF WISCONSIN SYSTEM NON PAYROLL
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 11/27/2024
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Provider Practice Location Address
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Address Line | 3351 N DOWNER AVE.
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City | MILWAUKEE
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State | WI
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Zip | 53211-0000
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Country | US
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Telephone | 414-229-6643
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Fax | 414-229-6608
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Provider Business Mailing Address
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Address Line | 3351 N DOWNER AVE.
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City | MILWAUKEE
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State | WI
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Zip | 53211-0000
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Country | US
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Telephone | 414-229-6643
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Fax | 414-229-6608
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | MRS. MARYANNE WAWRZYN
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Credential | RPH
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Telephone | 414-229-6643
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 7046-042
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License Number State | WI
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