NPIMap

Organization Active NPI

Froedtert Health Pharmacy LLC

Doing business as Froedtert Pharmacy 075

  • Community/Retail Pharmacy
  • Milwaukee, WI
National Provider Identifier
1790333623
Registry record updated Jan 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
FROEDTERT HEALTH PHARMACY LLC
Doing business as
Froedtert Pharmacy 075
Practice address
900 N 92ND St
Milwaukee, WI 53226-1202
Phone
(414) 805-5115
Fax
(262) 532-5105
NPI assigned
Sep 4, 2019
Last updated
Jan 16, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dale Drizd
Title
Exec Dir FH Pharmacy Solutions
Phone
(262) 532-5168

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Clinic Pharmacy 3336C0002X NU
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

900 N 92ND St
Milwaukee, WI 53226-1202

Mailing address

N86W12999 Nightingale Way
Menomonee Falls, WI 53051-2102
Phone (262) 532-5163

Other names 1

  • Froedtert Pharmacy 075 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20191216000207 WI Part B Supplier - Pharmacy 0749613222 14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Manitowoc, WI; West Bend, WI; Wauwatosa, WI; Oak Creek, WI; New Berlin, WI; Milwaukee, WI; Menomonee Falls, WI; Mequon, WI
O20200110001150 WI DME Supplier - Pharmacy 0749613222 Practice locations: Milwaukee, WI

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 14

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 14

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Froedtert Health Pharmacy LLC900 N 92ND St, Milwaukee, WI 53226-1202(414) 805-5115 Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order) Accepts assignmentParticipating since Nov 3, 2019

National Provider Directory

National Provider Directory
Tax ID family
Froedtert Health Pharmacy LLC19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1567555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673827200000",
    "number": "1790333623",
    "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": "262-532-5163",
            "fax_number": "262-532-5105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N 92ND ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532261202",
            "telephone_number": "414-805-5115",
            "fax_number": "262-532-5105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FROEDTERT HEALTH PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-04",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-16",
        "status": "A",
        "authorized_official_last_name": "DRIZD",
        "authorized_official_first_name": "DALE",
        "authorized_official_title_or_position": "EXEC DIR FH PHARMACY SOLUTIONS",
        "authorized_official_telephone_number": "262-532-5168"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Froedtert Pharmacy 075",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Froedtert Pharmacy 075",
            "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 Jan 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.