1669885471 NPI number — WAUWATOSA PRESCRIPTION CENTER, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669885471 NPI number — WAUWATOSA PRESCRIPTION CENTER, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WAUWATOSA PRESCRIPTION CENTER, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669885471
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/25/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1997
Provider Second Line Business Mailing Address:
MS 900 ROSALIE O'MEARA
Provider Business Mailing Address City Name:
MILWAUKEE
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53201-1997
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
414-266-6223
Provider Business Mailing Address Fax Number:
414-266-1894

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4855 S MOORLAND ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW BERLIN
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53151
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
262-432-7613
Provider Business Practice Location Address Fax Number:
414-266-1894
Provider Enumeration Date:
06/09/2014

Additional Information

Authorized Official

Authorized Official Last Name:
CADIEUX
Authorized Official First Name:
MARC
Authorized Official Middle Name:
Authorized Official Title or Position:
CORPORATE VP/CFO
Authorized Official Telephone Number:
414-266-6226

Provider Taxonomy Codes

  • Taxonomy code: 3336S0011X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com