Provider Demographics
NPI:1245395169
Name:RONALD DROBAC, TOSA PHARMACY
Entity Type:Organization
Organization Name:RONALD DROBAC, TOSA PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:DROBAC
Authorized Official - Suffix:
Authorized Official - Credentials:R PH
Authorized Official - Phone:414-462-1700
Mailing Address - Street 1:9235 W CAPITOL DR
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53222-1567
Mailing Address - Country:US
Mailing Address - Phone:414-462-1700
Mailing Address - Fax:414-462-4170
Practice Address - Street 1:9235 W CAPITOL DR
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53222-1567
Practice Address - Country:US
Practice Address - Phone:414-462-1700
Practice Address - Fax:414-462-4170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7713-040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI5116810OtherNABP
WI33042500Medicaid
WI33042500Medicaid