Provider Demographics
NPI:1215204904
Name:SVEHLEK, GARY ALAN (RPH)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:ALAN
Last Name:SVEHLEK
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 1:18335 MILWAUKEE AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-3462
Mailing Address - Country:US
Mailing Address - Phone:262-785-2670
Mailing Address - Fax:
Practice Address - Street 1:18335 MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-3462
Practice Address - Country:US
Practice Address - Phone:262-785-2670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-22
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9817-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist