Provider Demographics
NPI:1215942842
Name:DRUGS R US
Entity type:Organization
Organization Name:DRUGS R US
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHTIVELBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-982-2160
Mailing Address - Street 1:3512 N OAKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53211-2701
Mailing Address - Country:US
Mailing Address - Phone:414-982-2160
Mailing Address - Fax:414-332-3364
Practice Address - Street 1:10520 N BAEHR RD STE G
Practice Address - Street 2:
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092-6701
Practice Address - Country:US
Practice Address - Phone:414-982-2160
Practice Address - Fax:414-332-3364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
WI8553-423336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI33287300Medicaid
WI100102840Medicaid
2110853OtherPK