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FROEDTERT MEMORIAL LUTHERAN HOSPITAL, INC.

Suppliers Pharmacy Clinic Pharmacy

Provider NPI: 1154597292

Organization Information:
Organization Name:  FROEDTERT MEMORIAL LUTHERAN HOSPITAL, INC.
Organization is not Subpart
Authorized Official:  KEVIN  PERHACH  BUSINESS MANAGER  414-805-6531

Practice Location:
9200 W WISCONSIN AVE STE 200C MILWAUKEE, WI 53226-3522 US
Tel: 414-805-0977  Fax: 414-805-0980

Business Mailing Address:
N86W12999 NIGHTINGALE WAY  MENOMONEE FALLS, WI 53051-2102 US
Tel: 262-532-5173  Fax: 262-532-5105

NPI Information:
NPI: 1154597292
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N3336C0002XSuppliers
Pharmacy
Clinic Pharmacy
N3336C0004XSuppliers
Pharmacy
N3336S0011XSuppliers
Pharmacy
Y3336C0003XSuppliers
Pharmacy
WI8837-42

Other Provider Identifiers:

IssuerNumberStateType
36226900WI05
PK211110501



American Medical Association 2012 taxonomy code information

Code: 3336C0003X

Type:

Classification:



Definition:



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