MEDICARE: ALYSSA AMRHEIN

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	21423-40	WI

General Provider Information

NPI Number	:	1962124297
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSSA AMRHEIN

Provider Business Mailing Address
First Line	:	956 7TH AVE
Second Line	:
City	:	GRAFTON
State	:	WI
Zip	:	53024-1421
Country	:	US
Telephone Number	:	262-365-1361
Fax Number	:

Provider Business Practice Location Address
First Line	:	11739 W BRADLEY RD
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53224-2531
Country	:	US
Telephone Number	:	800-477-7221
Fax Number	:

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

Provider Enumeration Date	:	09/13/2022
Last Update Date	:	09/13/2022

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Directions to “ ALYSSA AMRHEIN ” Practice Location

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