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General NPI Number Information
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NPI Number | 1528311933
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Entity Type | Organization
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Legal Business Name | ZAIBAK PRN LLC
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Dates
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Enumeration Date | 10/23/2012
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Last Update Date | 05/27/2016
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Provider Practice Location Address
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Address Line | 8500 W CAPITOL DR
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City | MILWAUKEE
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State | WI
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Zip | 53222-1869
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Country | US
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Telephone | 414-463-1111
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Fax | 414-463-1112
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Provider Business Mailing Address
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Address Line | 8500 W CAPITOL DR
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City | MILWAUKEE
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State | WI
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Zip | 53222-1869
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Country | US
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Telephone | 262-923-1444
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Fax | 262-923-1444
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Authorized Official
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Title or Position | PHARMACIST MANAGER/OWNER
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Name | HASHIM ZAIBAK
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Credential |
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Telephone | 414-712-5200
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 9167-42
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License Number State | WI
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