Provider Demographics
NPI:1669642492
Name:BOGHOSSIAN, KARA A (RPH PHARMD)
Entity type:Individual
Prefix:DR
First Name:KARA
Middle Name:A
Last Name:BOGHOSSIAN
Suffix:
Gender:F
Credentials:RPH PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9000 W WISCONSIN AVE
Mailing Address - Street 2:SUITE 235
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4874
Mailing Address - Country:US
Mailing Address - Phone:414-266-1893
Mailing Address - Fax:414-266-1894
Practice Address - Street 1:9000 W WISCONSIN AVE
Practice Address - Street 2:SUITE 235
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-4874
Practice Address - Country:US
Practice Address - Phone:414-266-1892
Practice Address - Fax:414-266-1894
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-07
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI14428-040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist