COMMUNITY MEMORIAL HOSPITAL OF MENOMONEE FALLS INC NPI 1063874824

NPI Information

  • NPI: 1063874824
  • Provider Name: COMMUNITY MEMORIAL HOSPITAL OF MENOMONEE FALLS INC
  • Classification: Pharmacy - 3336C0003X
  • Specialization: Community/Retail Pharmacy
  • Entity Type: Organization
  • Doing Business As: FROEDTERT & MCW MOORLAND RESERVE HEALTH CENTER PHARMACY
  • CLIA Number: 52D2128531
  • Address: 4805 S MOORLAND RD RM G0502A
    NEW BERLIN, WI
    ZIP 53151
  • Phone: (262) 798-7386

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NPI Details

COMMUNITY MEMORIAL HOSPITAL OF MENOMONEE FALLS INC is a community/retail pharmacy pharmacy in New Berlin, WI. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. COMMUNITY MEMORIAL HOSPITAL OF MENOMONEE FALLS INC NPI is 1063874824. The provider is registered as an organization entity type.
The provider Is Doing Business As Froedtert & Mcw Moorland Reserve Health Center Pharmacy.

The provider's business location address is:

4805 S MOORLAND RD RM G0502A
NEW BERLIN, WI
ZIP 53151-401
Phone: (262) 798-7386
Fax: (262) 798-7320

The provider's authorized official is Kevin Perhach .
The authorized official title is Business Manager and has the following contact phone number (414) 805-6531.

The CLIA number assigned to this NPI record is 52D2128531 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 3/22/2016 and was last updated on 7/28/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1333600000XPharmacyNo
23336C0002XPharmacyClinic PharmacyNo
33336C0003XPharmacyCommunity/Retail Pharmacy9396-42WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11063874824MEDICAIDWISCONSIN
22158809OTHERPK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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