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NPI Code Detail

MEDICARE: CAROL HERMANN R.PH.

MEDICARE: CAROL HERMANN R.PH.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist11748-40WI

General Provider Information

NPI Number : 1275096786
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROL HERMANN R.PH.
Provider Business Mailing Address
First Line : 118 VILAS HIBBARD PKWY
Second Line :
City : LODI
State : WI
Zip : 53555-1360
Country : US
Telephone Number : 608-444-3163
Fax Number :
Provider Business Practice Location Address
First Line : 5185 S 9TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53221-3627
Country : US
Telephone Number : 608-444-3163
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2019
Last Update Date : 04/11/2019

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Directions to “ CAROL HERMANN R.PH.” Practice Location

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