Provider Demographics
NPI:1902965908
Name:NEUHAUSER PHARMACIES INC
Entity Type:Organization
Organization Name:NEUHAUSER PHARMACIES INC
Other - Org Name:NEUHAUSER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PEG
Authorized Official - Middle Name:
Authorized Official - Last Name:BREUER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:608-256-8712
Mailing Address - Street 1:1875 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711-2024
Mailing Address - Country:US
Mailing Address - Phone:608-256-8712
Mailing Address - Fax:608-256-3027
Practice Address - Street 1:1875 MONROE ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711-2024
Practice Address - Country:US
Practice Address - Phone:608-256-8712
Practice Address - Fax:608-256-3027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
WI6365-423336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2112798OtherPK
WI33025700Medicaid
0838140001Medicare NSC