NPIMap

Organization Active NPI

Froedtert Memorial Lutheran Hospital, Inc.

  • Community/Retail Pharmacy
  • Milwaukee, WI
National Provider Identifier
1154597292
Registry record updated Jan 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
8837-42 Issued in WI
Legal business name
FROEDTERT MEMORIAL LUTHERAN HOSPITAL, INC.
Practice address
9200 W Wisconsin Ave
Ste 200C
Milwaukee, WI 53226-3522
Phone
(414) 805-0977
Fax
(414) 805-0980
NPI assigned
May 7, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2020

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

Authorized official

Name
Kevin Perhach
Title
Business Manager
Phone
(414) 805-6531

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X
Community/Retail Pharmacy 3336C0003X 8837-42 WI Primary
Compounding Pharmacy 3336C0004X
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

9200 W Wisconsin Ave
Ste 200C
Milwaukee, WI 53226-3522

Mailing address

N86W12999 Nightingale Way
Menomonee Falls, WI 53051-2102
Phone (262) 532-5173

Other identifiers 2

IdentifierTypeStateIssuer
36226900MedicaidWI
2111105OtherPK

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1210118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580342400000",
    "number": "1154597292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N86W12999 NIGHTINGALE WAY",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530512102",
            "telephone_number": "262-532-5173",
            "fax_number": "262-532-5105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "address_2": "STE 200C",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-0977",
            "fax_number": "414-805-0980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FROEDTERT MEMORIAL LUTHERAN HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-07",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A",
        "authorized_official_last_name": "PERHACH",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "414-805-6531"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "8837-42",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36226900",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2111105",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2020; 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.