Provider Demographics
NPI:1316049109
Name:MORGANO, PAUL GERARD (RPH)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:GERARD
Last Name:MORGANO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9171 S 42ND ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-9393
Mailing Address - Country:US
Mailing Address - Phone:414-761-9083
Mailing Address - Fax:
Practice Address - Street 1:ZABLOCKI DEPT OF VETERANS AFFAIRS MEDICAL CTR
Practice Address - Street 2:5000 W NATIONAL AVE
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53295-0001
Practice Address - Country:US
Practice Address - Phone:414-384-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI12008-040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist