Cedar Lake Campus Pharmacy

LBN: Benevolent Corporation Cedar Community
Cedar Lake Campus Pharmacy is an health care organization with primary practice located at 5595 County Road Z , West Bend WI 53095-9224. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Pharmacy is the primary health care specialty. Benevolent Corporation Cedar Community can be contacted via phone (262) 306-2140, or through Pichler, Joseph T via phone (262) 306-4212.

Contact Information

Primary practice address
5595 County Road Z West Bend WI 53095-9224
Phone: (262) 306-2140
Fax: (262) 306-2141
Website:
Map and Directions
Authorized official contact:
Name: Pichler, Joseph T
Phone: (262) 306-4212

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X 5115503 Wisconsin
Suppliers / Long Term Care Pharmacy 3336L0003X 5115503 Wisconsin

Profile Details

NPI number 1154321602
LBN Legal business name Benevolent Corporation Cedar Community
DBA Doing business as Cedar Lake Campus Pharmacy
Authorized official Pichler, Joseph T
Entity Organization
Organization subpart 1 Yes
Enumeration date Jul 27th, 2005
Last updated Dec 30th, 2020 - about 5 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 1154321602 NPPES
Wisconsin MEDICAID 33027100

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