NPI: 1669020855 · WEST BEND, WI 53095 · Pharmacy · NPI assigned 08/30/2019
| Authorized Official | PERHACH, KEVIN (BUSINESS MANAGER) |
| NPI Enumeration Date | 08/30/2019 |
Other providers sharing the same authorized official: PERHACH, KEVIN
| Provider | City | State | Total Paid |
|---|---|---|---|
| FROEDTERT HEALTH HOME INFUSION LLC | MENOMONEE FALLS | WI | $75K |
| FROEDTERT HEALTH PHARMACY LLC | NEW BERLIN | WI | $7K |
| FROEDTERT HEALTH PHARMACY LLC | OAK CREEK | WI | $6K |
| FROEDTERT HEALTH PHARMACY LLC | WAUWATOSA | WI | $4K |
| FROEDTERT HEALTH PHARMACY LLC | MENOMONEE FALLS | WI | $3K |
| FROEDTERT HEALTH PHARMACY LLC | MILWAUKEE | WI | $496.08 |
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 13 | $248.28 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 90656 | 13 | 13 | $248.28 |