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General NPI Number Information
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NPI Number | 1912796228
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Entity Type | Organization
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Legal Business Name | XPERIENCE PHARMACY 2 LLC
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Dates
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Enumeration Date | 05/02/2025
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 4270 N 76TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53222-2002
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Country | US
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Telephone | 414-988-2188
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Fax |
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Provider Business Mailing Address
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Address Line | 5715 W APPLETON AVE
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City | MILWAUKEE
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State | WI
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Zip | 53210-2250
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Country | US
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Telephone | 414-988-2188
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Fax | 414-988-2187
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Authorized Official
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Title or Position | PART OWNER/PHARMACIST
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Name | DEBBIE SADE ISIEKWENE
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Credential | PHARMD
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Telephone | 773-432-5594
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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