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General NPI Number Information
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NPI Number | 1609930825
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Entity Type | Organization
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Legal Business Name | WISCONSIN COMMUNITY SERVICES, INC.
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 12/05/2017
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Provider Practice Location Address
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Address Line | 3734 W WISCONSIN AVE
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City | MILWAUKEE
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State | WI
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Zip | 53208
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Country | US
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Telephone | 414-343-3543
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Fax | 414-344-3176
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Provider Business Mailing Address
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Address Line | 3734 W WISCONSIN AVE
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City | MILWAUKEE
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State | WI
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Zip | 53208
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Country | US
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Telephone | 414-343-3543
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Fax | 414-344-3176
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Authorized Official
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Title or Position | MANAGING PHARMACIST
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Name | LINDSAY PERRY
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Credential | PHARMD
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Telephone | 414-343-3543
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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 | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 8454042
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number |
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License Number State |
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