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General NPI Number Information
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NPI Number | 1669885471
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Entity Type | Organization
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Legal Business Name | WAUWATOSA PRESCRIPTION CENTER, INC.
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Dates
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Enumeration Date | 06/09/2014
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Last Update Date | 09/25/2019
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Provider Practice Location Address
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Address Line | 4855 S MOORLAND ROAD
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City | NEW BERLIN
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State | WI
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Zip | 53151
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Country | US
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Telephone | 262-432-7613
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Fax | 414-266-1894
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Provider Business Mailing Address
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Address Line | PO BOX 1997 MS 900 ROSALIE O'MEARA
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City | MILWAUKEE
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State | WI
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Zip | 53201-1997
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Country | US
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Telephone | 414-266-6223
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Fax | 414-266-1894
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Authorized Official
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Title or Position | CORPORATE VP/CFO
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Name | MARC CADIEUX
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Credential |
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Telephone | 414-266-6226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty 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 | 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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