NPI: 1164509949 · WEST ALLIS, WI 53214 · Specialty Pharmacy · NPI assigned 11/01/2006
| Authorized Official | PEARSON, RICHARD (PRESIDENT) |
| NPI Enumeration Date | 11/01/2006 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 24 | $663.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 90686 | 24 | 22 | $663.00 |