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General NPI Number Information
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NPI Number | 1730282880
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Entity Type | Organization
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Legal Business Name | CEDARBURG PRESCRIPTION CENTER INC
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 03/20/2023
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Provider Practice Location Address
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Address Line | N54W6135 MILL ST STE 300
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City | CEDARBURG
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State | WI
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Zip | 53012-2021
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Country | US
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Telephone | 262-375-0010
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Fax | 262-375-0080
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Provider Business Mailing Address
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Address Line | N54W6135 MILL ST STE 300
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City | CEDARBURG
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State | WI
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Zip | 53012-2021
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Country | US
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Telephone | 262-375-0010
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Fax | 262-375-0080
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Authorized Official
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Title or Position | OWNER
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Name | KYLE BEYER
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Credential |
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Telephone | 414-232-4103
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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 | 054.018973
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License Number State | IL
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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 | 22-44771
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 7808-42
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH29535
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License Number State | FL
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