Provider Demographics
NPI:1134727902
Name:LEE, TU ANH LAM (PHARMD)
Entity type:Individual
Prefix:
First Name:TU ANH
Middle Name:LAM
Last Name:LEE
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 1:600 N SPRINGDALE RD
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53186-1815
Mailing Address - Country:US
Mailing Address - Phone:262-798-1580
Mailing Address - Fax:
Practice Address - Street 1:600 N SPRINGDALE RD
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53186-1815
Practice Address - Country:US
Practice Address - Phone:262-798-1580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.301566183500000X
WI19746-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist