NPIMap

Organization Active NPI

Oncology Alliance

  • Non-Pharmacy Dispensing Site
  • Wauwatosa, WI
National Provider Identifier
1013963404
Registry record updated Nov 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
21799020 Issued in WI
Legal business name
ONCOLOGY ALLIANCE
Practice address
1055 N Mayfair Rd
Wauwatosa, WI 53226-3436
Phone
(414) 479-8450
Fax
(414) 479-8670
NPI assigned
May 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dudley Blank, RPH
Title
Dir of Pharm
Phone
(414) 906-4400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X 21799020 WI Primary

Addresses

Primary practice location

1055 N Mayfair Rd
Wauwatosa, WI 53226-3436

Mailing address

1055 N Mayfair Rd
Wauwatosa, WI 53226-3436

Other identifiers 3

IdentifierTypeStateIssuer
32836000MedicaidWI
5129588OtherOTHER ID NUMBER-COMMERCIAL NUMBER
5129588OtherOTHER ID NUMBER

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195603200000",
    "number": "1013963404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N MAYFAIR RD",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532263436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 N MAYFAIR RD",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532263436",
            "telephone_number": "414-479-8450",
            "fax_number": "414-479-8670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONCOLOGY ALLIANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2007-11-21",
        "status": "A",
        "authorized_official_last_name": "BLANK",
        "authorized_official_first_name": "DUDLEY",
        "authorized_official_title_or_position": "DIR OF PHARM",
        "authorized_official_telephone_number": "414-906-4400",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "WI",
            "license": "21799020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32836000",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "5129588",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "5129588",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.