Provider Demographics
NPI:1598580003
Name:RESTINA POLOVIC CONSULTING LLC
Entity type:Organization
Organization Name:RESTINA POLOVIC CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RESTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:POLOVIC
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:414-975-8199
Mailing Address - Street 1:8240 S 88TH ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-9704
Mailing Address - Country:US
Mailing Address - Phone:414-975-8199
Mailing Address - Fax:
Practice Address - Street 1:201 JAMES ST
Practice Address - Street 2:
Practice Address - City:DE PERE
Practice Address - State:WI
Practice Address - Zip Code:54115-2562
Practice Address - Country:US
Practice Address - Phone:414-975-8199
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistGroup - Single Specialty