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General NPI Number Information
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NPI Number | 1346787124
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Entity Type | Organization
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Legal Business Name | SHIKRET, INC
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Dates
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Enumeration Date | 01/31/2017
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Last Update Date | 02/23/2017
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Provider Practice Location Address
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Address Line | 1238 S CESAR E CHAVEZ DR
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City | MILWAUKEE
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State | WI
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Zip | 53204-2267
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Country | US
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Telephone | 414-333-2478
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Fax |
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Provider Business Mailing Address
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Address Line | 5335 W RIVER TRAIL RD
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City | MEQUON
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State | WI
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Zip | 53092-4876
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ALEXANDER SHISTER
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Credential |
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Telephone | 414-333-2478
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 9441-42
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License Number State | WI
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