Provider Demographics
NPI:1184102840
Name:AREMKA, JACLYN (PHARMD)
Entity type:Individual
Prefix:
First Name:JACLYN
Middle Name:
Last Name:AREMKA
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 1:16445 W WISCONSIN AVE UNIT 2
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-5776
Mailing Address - Country:US
Mailing Address - Phone:847-404-3650
Mailing Address - Fax:
Practice Address - Street 1:4777 S 27TH ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53221-2601
Practice Address - Country:US
Practice Address - Phone:414-282-0634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-03
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI19507-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist