Victoria Lee Sobczak, R.PH.
Individual provider Active NPI Pharmacist · De Forest, WI
NPI 1245331990 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1245331990
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 11196-040 (WI)
- Practice address
- 645 S Main St
De Forest, WI 53532-1421 - Phone
- (608) 846-4736
- NPI assigned
- Sep 26, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11196-040 | WI | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 11196-040 | WI | Yes |
Addresses
Primary practice location
645 S Main St
De Forest, WI 53532-1421
Mailing address
620 Overlook Ter
De Forest, WI 53532-3046
Phone (608) 846-2920
Other providers in De Forest, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.