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General NPI Number Information
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NPI Number | 1275096786
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Entity Type | Individual
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Provider Name | CAROL HERMANN R.PH.
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Gender | Female
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Dates
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Enumeration Date | 04/11/2019
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Last Update Date | 04/11/2019
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Provider Practice Location Address
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Address Line | 5185 S 9TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53221-3627
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Country | US
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Telephone | 608-444-3163
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Fax |
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Provider Business Mailing Address
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Address Line | 118 VILAS HIBBARD PKWY
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City | LODI
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State | WI
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Zip | 53555-1360
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Country | US
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Telephone | 608-444-3163
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 11748-40
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License Number State | WI
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