CUDAHY CLINIC PHCY INC (NPI# 1124039771) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124039771 |
| Entity Type | Organization |
| Organization Name | CUDAHY CLINIC PHCY INC |
| Other Organization Name | CUDAHY CLINIC SERV U PHCY |
| Practice Address |
3533 E Ramsey Ave Cudahy WI 53110-3009 |
| Practice Telephone | 4147696150 |
| Practice Fax Number | 4147691551 |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2007-10-16 |
| Authorized Official Name | PETER TOPOLOVICH (OWNER) |
| Authorized Official Telephone | 4147696150 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
6574042 | WI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 33046100 | 05 | |
| OTHER ID NUMBER | 5117064 | 01 | |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 5117064 | 01 |
| Other Name | Type Code |
|---|---|
| CUDAHY CLINIC SERV U PHCY | Doing Business As Name - Organization |
| Street Address |
3533 E RAMSEY AVE |
| City | CUDAHY |
| State | WI |
| Zip Code | 53110-3009 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912903345 | Lee Ross Schoenenberger | Specialist | 3533 E Ramsey Ave, Cudahy, WI 53110-3009 | 2005-06-21 |
| 1912028382 | Rudolfo G Burgos | Radiology | 3533 E Ramsey Ave, Cudahy, WI 53110-3009 | 2007-04-03 |
| 1215018825 | Wheaton Franciscan Medical Group | Internal Medicine | 3533 E Ramsey Ave, Cudahy, WI 53110-3009 | 2006-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164059150 | Access Mobility Vans, Inc. | Durable Medical Equipment & Medical Supplies | 1995 E. Norse Ave., Cudahy, WI 53110 | 2020-03-27 |
| 1497191357 | Kristel Roebbeke | Occupational Therapist | 4157 W College Ave, Milwaukee, WI 53110 | 2013-05-20 |
| 1568684058 | City of Cudahy | Case Management | 5050 South Lake Drive, Cudahy, WI 53110 | 2007-05-03 |
| 1104854363 | Mathew George Mathai | Internal Medicine | 5900 S. Lake Dr., Cudahy, WI 53110 | 2006-06-28 |
| 1174917199 | Alyssa Kaleta | Internal Medicine | 5900 S Lake Dr, Cudahy, WI 53110 | 2015-03-27 |
| 1740546829 | Fatima Ali | Family Medicine | 5900 S Lake Dr, Cudahy, WI 53110 | 2012-04-03 |
| 1609003508 | Elizabeth A Vissat | Podiatrist | 5900 S Lake Dr, 2 West, Cudahy, WI 53110 | 2009-06-18 |
| 1366616864 | Miguel A Aguilera | Anesthesiology | 5900 S Lake Dr, Cudahy, WI 53110 | 2008-04-15 |
| 1235355983 | Aurora Health Care Metro, Inc. | Clinic/Center | 5900 S Lake Drive, Cudahy, WI 53110 | 2007-04-18 |
| 1114005618 | Manila Sodhi | Internal Medicine | 5900 S Lake Dr, 2 West, Cudahy, WI 53110 | 2006-11-01 |
| Find all providers in zip 53110 | ||||
| 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 |
|---|---|---|---|---|
| 1730659962 | Hayat Pharmacy 12 | Pharmacy | 5911 S Packard Ave, Cudahy, WI 53110-3025 | 2018-11-30 |
| 1346281219 | Wisconsin Cvs Pharmacy LLC | Pharmacy | 5740 S Packard Ave, Cudahy, WI 53110-2659 | 2006-06-09 |
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|---|---|---|---|---|
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| 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 |
| 1295377703 | Hayat Pharmacy 21 LLC. | Pharmacy | 2333 Northwestern Ave Ste 120, Racine, WI 53404-2520 | 2019-10-16 |
| 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 |
| 1275182925 | Walgreen Co | Pharmacy | 2265 N Mayfair Rd, Wauwatosa, WI 53226-2207 | 2019-09-05 |
| 1982257200 | Hayat Pharmacy 16 LLC | Pharmacy | 603 N 36th St, Milwaukee, WI 53208-3826 | 2019-07-17 |
| Find all providers with the same taxonomy | ||||
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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.