13Th Street Pharmacy Llc

LBN: 13Th Street Pharmacy Llc
13Th Street Pharmacy Llc is an health care organization with primary practice located at 1320 W Burnham St , Milwaukee WI 53204-3248. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. 13Th Street Pharmacy Llc can be contacted via phone (414) 383-4111, or through Shtivelberg, Russel via phone (414) 324-9393.

Contact Information

Primary practice address
1320 W Burnham St Milwaukee WI 53204-3248
Phone: (414) 383-4111
Fax: (414) 383-2248
Website:
Map and Directions
Authorized official contact:
Name: Shtivelberg, Russel
Phone: (414) 324-9393

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X 9131-42 Wisconsin

Profile Details

NPI number 1679835326
LBN Legal business name 13Th Street Pharmacy Llc
DBA Doing business as 13Th Street Pharmacy Llc
Authorized official Shtivelberg, Russel
Entity Organization
Organization subpart 1 No
Enumeration date Jun 8th, 2012
Last updated Dec 3rd, 2014 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679835326 NPPES
Wisconsin MEDICAID 100023902
Wisconsin Other 2135508

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