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NPI Code Detail

MEDICARE: THOMAS JOHN VICK PHARMD

MEDICARE: THOMAS JOHN VICK PHARMD
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
1183500000XPharmacist13686-40WI

General Provider Information

NPI Number : 1326314915
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS JOHN VICK PHARMD
Provider Business Mailing Address
First Line : 900 N 92ND ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53226-1202
Country : US
Telephone Number : 414-805-5115
Fax Number : 414-805-7961
Provider Business Practice Location Address
First Line : 900 N 92ND ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53226-1202
Country : US
Telephone Number : 414-805-5115
Fax Number : 414-805-7961
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2012
Last Update Date : 05/09/2023

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Directions to “ THOMAS JOHN VICK PHARMD” Practice Location

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