Kathryn Marie Forecki, PHARMD
Individual provider Active NPI Pharmacist · Greendale, WI
NPI 1477152155 · NPPES record last updated Oct 22, 2020
Key facts
- NPI
- 1477152155
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 14778-40 (WI)
- Practice address
- 5301 S 76TH St
Greendale, WI 53129-1128 - Phone
- (414) 978-9019
- NPI assigned
- Oct 22, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14778-40 | WI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wal-Mart Stores East, LP | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 14778-40 | WI | Yes |
Addresses
Primary practice location
5301 S 76TH St
Greendale, WI 53129-1128
Mailing address
5301 S 76TH St
Greendale, WI 53129-1128
Phone (414) 978-9019
Other providers in Greendale, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 22, 2020. 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.