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General NPI Number Information
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NPI Number | 1598580003
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Entity Type | Organization
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Legal Business Name | RESTINA POLOVIC CONSULTING LLC
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Dates
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Enumeration Date | 11/19/2024
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 201 JAMES ST
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City | DE PERE
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State | WI
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Zip | 54115-2562
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Country | US
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Telephone | 414-975-8199
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Fax |
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Provider Business Mailing Address
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Address Line | 8240 S 88TH ST
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City | FRANKLIN
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State | WI
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Zip | 53132-9704
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Country | US
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Telephone | 414-975-8199
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | RESTINA POLOVIC
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Credential | R.PH.
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Telephone | 414-975-8199
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number |
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License Number State |
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