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NPI Code Detail

MEDICARE: MEDA A. TUTILA PHARMD

MEDICARE: MEDA A. TUTILA 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
1183500000XPharmacist051.296392IL
2183500000XPharmacist17301-40WI

General Provider Information

NPI Number : 1598387508
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEDA A. TUTILA PHARMD
Provider Business Mailing Address
First Line : 8700 N PORT WASHINGTON RD APT 311
Second Line :
City : FOX POINT
State : WI
Zip : 53217-2211
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 240 E HAMPTON RD
Second Line :
City : WHITEFISH BAY
State : WI
Zip : 53217-5850
Country : US
Telephone Number : 414-962-7071
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2020
Last Update Date : 05/12/2020

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Directions to “ MEDA A. TUTILA PHARMD” Practice Location

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