Active NPI
Robert John Udhardt, RPH
- Pharmacist
- Milwaukee, WI
National Provider Identifier
1578929246
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 40-9161
- Practice address
- 6901 W Edgerton Ave
Milwaukee, WI 53220-4420 - Phone
- (414) 325-5236
- NPI assigned
- Jan 11, 2016
- Last updated
- Jan 11, 2016
- Sex
- Male
- Sole proprietor
- No
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 | 40-9161 | WI | Primary |
Addresses
Primary practice location
6901 W Edgerton Ave
Milwaukee, WI 53220-4420
Mailing address
5773 Eldon St
Greendale, WI 53129-1631
Phone (414) 421-0582
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 |
|---|---|---|---|
| 40-9161 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1452470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452470400000",
"number": "1578929246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5773 ELDON ST",
"city": "GREENDALE",
"state": "WI",
"postal_code": "531291631",
"telephone_number": "414-421-0582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6901 W EDGERTON AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532204420",
"telephone_number": "414-325-5236"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UDHARDT",
"first_name": "ROBERT",
"middle_name": "JOHN",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-01-11",
"last_updated": "2016-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "40-9161",
"primary": true
}
],
"identifiers": [],
"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 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.