Provider Demographics
NPI:1710518451
Name:NS HEALTH CARE LLC
Entity Type:Organization
Organization Name:NS HEALTH CARE LLC
Other - Org Name:NORTH SHORE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BEYER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:414-232-4103
Mailing Address - Street 1:1421 E CAPITOL DR
Mailing Address - Street 2:
Mailing Address - City:SHOREWOOD
Mailing Address - State:WI
Mailing Address - Zip Code:53211-1956
Mailing Address - Country:US
Mailing Address - Phone:414-962-9665
Mailing Address - Fax:414-962-4590
Practice Address - Street 1:1421 E CAPITOL DR
Practice Address - Street 2:
Practice Address - City:SHOREWOOD
Practice Address - State:WI
Practice Address - Zip Code:53211-1956
Practice Address - Country:US
Practice Address - Phone:414-962-9665
Practice Address - Fax:414-962-4590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-31
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1316009038Medicaid