NPIMap

Organization Active NPI

Froedtert Memorial Lutheran Hospital, Inc.

  • Community/Retail Pharmacy
  • Milwaukee, WI
National Provider Identifier
1356722045
Registry record updated Nov 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
9309-42 Issued in WI
Legal business name
FROEDTERT MEMORIAL LUTHERAN HOSPITAL, INC.
Practice address
9200 W Wisconsin Ave
Cfac Pharmacy
Milwaukee, WI 53226-3522
Phone
(414) 805-1295
Fax
(414) 805-1299
NPI assigned
Jun 18, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2017

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Clinic Pharmacy 3336C0002X
Community/Retail Pharmacy 3336C0003X 9309-42 WI Primary

Addresses

Primary practice location

9200 W Wisconsin Ave
Cfac Pharmacy
Milwaukee, WI 53226-3522

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
1356722045MedicaidWI
2152531OtherPK

Other names 1

  • Center for Advanced Care Pharmacy Doing business as

National Provider Directory

National Provider Directory

Locations

N74W12501 Leatherwood Ct
Ste 306
Menomonee Falls, WI 53051

NPI Registry JSON

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

{
    "created_epoch": "1434585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511222400000",
    "number": "1356722045",
    "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": "CFAC PHARMACY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-1295",
            "fax_number": "414-805-1299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FROEDTERT MEMORIAL LUTHERAN HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-18",
        "last_updated": "2017-11-21",
        "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": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "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": "9309-42",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356722045",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2152531",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Advanced Care Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 21, 2017; 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.