Provider Demographics
NPI:1225311434
Name:ALDRIDGE, ANGELA (PHARM D)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:ALDRIDGE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W168S6967 PARKLAND DR
Mailing Address - Street 2:
Mailing Address - City:MUSKEGO
Mailing Address - State:WI
Mailing Address - Zip Code:53150-8332
Mailing Address - Country:US
Mailing Address - Phone:414-852-1995
Mailing Address - Fax:
Practice Address - Street 1:15170 W GREENFIELD AVE
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-7018
Practice Address - Country:US
Practice Address - Phone:262-782-2787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-23
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15065-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist