Active NPI
Paul George Klubertanz, RPH
- Pharmacist
- Waukesha, WI
National Provider Identifier
1306133996
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 9974-40
- Practice address
- 2401 Kossow Rd
Waukesha, WI 53186-2904 - Phone
- (262) 784-8417
- Fax
- (262) 784-8417
- NPI assigned
- Jul 1, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 9974-40 | WI | Primary |
Addresses
Primary practice location
2401 Kossow Rd
Waukesha, WI 53186-2904
Mailing address
1406 Erin LN
Waukesha, WI 53188-4968
Phone (262) 549-3052
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9974-40 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309478400000",
"number": "1306133996",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1406 ERIN LN",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531884968",
"telephone_number": "262-549-3052",
"fax_number": "262-784-8417"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2401 KOSSOW RD",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531862904",
"telephone_number": "262-784-8417",
"fax_number": "262-784-8417"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLUBERTANZ",
"first_name": "PAUL",
"middle_name": "GEORGE",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-07-01",
"last_updated": "2011-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "9974-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waukesha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.