MEDICARE: ANDREW L TANG

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
1	183500000X	Pharmacist	246401	AK
2	183500000X	Pharmacist	23284-40	WI

General Provider Information

NPI Number	:	1659237915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW L TANG

Provider Business Mailing Address
First Line	:	2301 N LAKE DR
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53211-4508
Country	:	US
Telephone Number	:	414-585-1000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2301 N LAKE DR
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53211-4508
Country	:	US
Telephone Number	:	414-585-1000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/31/2025
Last Update Date	:	12/31/2025

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Directions to “ ANDREW L TANG ” Practice Location

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