Provider Demographics
NPI:1952501538
Name:CAUBLE, MONICA GOMEZ (PHARMD)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:GOMEZ
Last Name:CAUBLE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 STATE STREET
Mailing Address - Street 2:SUITE G
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703
Mailing Address - Country:US
Mailing Address - Phone:608-251-4454
Mailing Address - Fax:608-251-3853
Practice Address - Street 1:341 STATE STREET
Practice Address - Street 2:SUITE G
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703
Practice Address - Country:US
Practice Address - Phone:608-251-4454
Practice Address - Fax:608-251-3853
Is Sole Proprietor?:No
Enumeration Date:2007-07-20
Last Update Date:2014-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45206183500000X
WI1730340183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist