Organization · Type 2 NPI

Benevolent Corporation Cedar Community

Pharmacy · West Bend, WI

NPI number 1154321602 Active

Practice location

5595 County Road Z
West Bend, WI 53095-9224

Fax (262) 306-2141

Specialties and licenses

Taxonomy	Code	License
Pharmacy Primary	333600000X	5115503 (WI)
Long Term Care Pharmacy	3336L0003X	5115503 (WI)

Pharmacy: A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is lo…

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NPI record

NPI: 1154321602
Entity type: Organization (Type 2)
Issued: Jul 27, 2005
Last updated: Dec 30, 2020
Status: Active
Subpart: Yes of Benevolent Corporation Cedar Community

Other names

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Cedar Lake Campus Pharmacy · doing business as

Authorized official

Mr. Joseph T Pichler
Vice President of Finance
(262) 306-4212

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1154321602

Benevolent Corporation Cedar Community's National Provider Identifier is 1154321602, issued on Jul 27, 2005. The primary taxonomy on file is Pharmacy (333600000X), and the practice location is in West Bend, WI. The record was last updated on Dec 30, 2020.