CCOURTLAND PROF. PHARMACY (NPI# 1750459814) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750459814 |
| Entity Type | Organization |
| Organization Name | CCOURTLAND PROF. PHARMACY |
| Other Organization Name | THE PHARMACY |
| Practice Address |
8430 W Capitol Dr Milwaukee WI 53222-1846 |
| Practice Telephone | 4144638550 |
| Practice Fax Number | 4144630227 |
| Mailing Telephone | 4144638550 |
| Mailing Fax Number | 4144630227 |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JAMES GOLLIN (OWNER) |
| Authorized Official Telephone | 4144638550 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
7480 | WI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 33144000 | 05 |
| Other Name | Type Code |
|---|---|
| The Pharmacy | Doing Business As Name - Organization |
| Street Address |
8430 W CAPITOL DR |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53222-1846 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215966510 | Sharon A. Doss | Internal Medicine | 8430 W Capitol Dr, Milwaukee, WI 53222-1846 | 2006-07-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477101673 | Dalaina Y Holliman | Technician | 7719 W Fiebrantz Ave, Milwaukee, WI 53222 | 2019-08-30 |
| 1083183016 | Umenia Marie White | Respite Care | 7726 W. Center Street, Apt 1, Milwaukee, WI 53222 | 2018-11-20 |
| 1003399445 | For Eyes Optical Co of Pennsylvania | Eyewear Supplier (Equipment, not the service) | 11450 W. Burleigh St, Wauwatosa, WI 53222 | 2018-09-12 |
| 1558852673 | Joseph Fleming | Physical Therapist | 11450 W Burleigh St, Ste 120, Wauwatosa, WI 53222 | 2018-05-24 |
| 1942739206 | Yolanda D. Burdine | Licensed Practical Nurse | 8327 W. Center St., Apt. 2, Milwaukee, WI 53222 | 2017-06-08 |
| 1558807131 | Midwest Nephrology Associates, Sc | Clinic/Center | 7797 W Appleton Avenue, Milwaukee, WI 53222 | 2017-01-06 |
| 1477097269 | Benjamin David Kluge | Pharmacist | 11111 W Burleigh Rd, Wauwatosa, WI 53222 | 2016-12-13 |
| 1841746989 | Elissa Hornick | Physician Assistant | 2885 N. Mayfair Rd., Wauwatosa, WI 53222 | 2016-08-29 |
| 1598218562 | Riley's Residential Home Care, LLC | In Home Supportive Care | 10111 W. Capitol Dr, Wauwatosa, WI 53222 | 2016-07-26 |
| 1346696796 | Respiratory and Sleep Services LLC | Durable Medical Equipment & Medical Supplies | 6529 W Fond Du Lac Avenue, Milwaukee, WI 53222 | 2016-05-04 |
| Find all providers in zip 53222 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| 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. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558906354 | Life Change Rx 4 LLC | Pharmacy | 6300 N 76th St Ste 246, Milwaukee, WI 53218-1208 | 2019-11-15 |
| 1285278978 | Life Change Rx 3 LLC | Pharmacy | 7115 W Capitol Dr, Milwaukee, WI 53216-2051 | 2019-11-05 |
| 1487296737 | Xperience Pharmacy LLC | Pharmacy | 5715 W Appleton Ave, Milwaukee, WI 53210-2250 | 2019-10-08 |
| 1962053421 | Hayat Pharmacy 19 LLC | Pharmacy | 805 W. Layton Ave. Suite A, Milwaukee, WI 53221 | 2019-09-26 |
| 1982257200 | Hayat Pharmacy 16 LLC | Pharmacy | 603 N 36th St, Milwaukee, WI 53208-3826 | 2019-07-17 |
| 1952965576 | Life Change Rx 1 LLC | Pharmacy | 813 S Layton Blvd, Milwaukee, WI 53215-1225 | 2019-04-29 |
| 1649706714 | Life Tree Pharmacy LLC | Pharmacy | 8329-5 W Appleton Ave, Milwaukee, WI 53218 | 2017-05-10 |
| 1366814980 | Hayat Pharmacy 7, LLC. | Pharmacy | 5312 W Villard Ave, Milwaukee, WI 53218-4345 | 2015-10-22 |
| 1689015521 | Roundys Supermarkets Inc | Pharmacy | 875 E Wisconsin Ave, Milwaukee, WI 53202-5404 | 2013-07-08 |
| 1679835326 | 13th Street Pharmacy LLC | Pharmacy | 1320 W Burnham St, Milwaukee, WI 53204-3248 | 2012-06-08 |
| Find all providers in MILWAUKEE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.