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General NPI Number Information
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NPI Number | 1811416639
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Entity Type | Organization
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Legal Business Name | COMMUNITY MEMORIAL HOSPITAL OF MENOMONEE FALLS INC
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Dates
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Enumeration Date | 09/13/2017
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Last Update Date | 07/19/2018
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Provider Practice Location Address
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Address Line | 7901 S 6TH ST
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City | OAK CREEK
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State | WI
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Zip | 53154-2010
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Country | US
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Telephone | 414-346-8050
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Fax | 262-532-5105
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Provider Business Mailing Address
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Address Line | N86W12999 NIGHTINGALE WAY
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City | MENOMONEE FALLS
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State | WI
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Zip | 53051-2102
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Country | US
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Telephone | 262-532-5163
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Fax |
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | KEVIN PERHACH
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Credential |
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Telephone | 262-532-5163
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 9462-42
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License Number State | WI
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