Hustad, Wayne
Hustad, Wayne is an sole proprietor health care provider with primary practice located at 6241 S Packard Ave , Cudahy WI 53110-3031. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Hustad, Wayne can be contacted via phone (414) 762-9717.Contact Information
Primary practice address
6241 S Packard Ave
Cudahy WI 53110-3031
Phone: (414) 762-9717
Fax: (414) 762-9720
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Pharmacy Service Providers / Pharmacist | 183500000X | 8817-40 | Wisconsin |
Profile Details
| NPI number | 1346524048 |
|---|---|
| LBN Legal business name | Hustad, Wayne |
| Credentials | R.PH. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 29th, 2011 |
| Last updated | Sep 29th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1346524048 | NPPES |
| Wisconsin | MEDICAID | 33149300 |
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