Provider Demographics
NPI:1275364606
Name:SCHIMBORSKI, MARIE (PHARMD)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:SCHIMBORSKI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15005 SAN RAPHAEL DR
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-3626
Mailing Address - Country:US
Mailing Address - Phone:414-507-2510
Mailing Address - Fax:
Practice Address - Street 1:443 PEWAUKEE RD
Practice Address - Street 2:
Practice Address - City:PEWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53072-5886
Practice Address - Country:US
Practice Address - Phone:262-956-6701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI22680-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist