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General NPI Number Information
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NPI Number | 1790121382
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Entity Type | Organization
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Legal Business Name | FHHP- KEWASKUM LLC
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Dates
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Enumeration Date | 05/22/2013
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 901 FOND DU LAC AVE
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City | KEWASKUM
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State | WI
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Zip | 53040-9161
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Country | US
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Telephone | 262-477-1700
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Fax | 262-477-1703
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Provider Business Mailing Address
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Address Line | 333 LOWVILLE RD
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City | RIO
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State | WI
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Zip | 53960-9437
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Country | US
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Telephone | 920-992-6800
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Fax | 920-614-6100
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Authorized Official
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Title or Position | OWNER
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Name | DANIEL STRAUSE
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Credential |
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Telephone | 920-992-6800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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 | 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 #3
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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 #4
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 9203-42
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License Number State | WI
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