=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245395169
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RONALD DROBAC, TOSA PHARMACY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/22/2006
-----------------------------------------------------
Last Update Date | 08/01/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9235 W CAPITOL DR
-----------------------------------------------------
City | MILWAUKEE
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53222-1567
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 414-462-1700
-----------------------------------------------------
Fax | 414-462-4170
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9235 W CAPITOL DR
-----------------------------------------------------
City | MILWAUKEE
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53222-1567
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 414-462-1700
-----------------------------------------------------
Fax | 414-462-4170
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHARMACIST-OWNER
-----------------------------------------------------
Name | MR. RONALD DROBAC
-----------------------------------------------------
Credential | R. PH.
-----------------------------------------------------
Telephone | 414-462-1700
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 7713-040
-----------------------------------------------------
License Number State | WI
-----------------------------------------------------