Provider Demographics
NPI:1700281607
Name:CALTEUX, RICHARD (RPH)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:CALTEUX
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9916 75TH ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53142-7583
Mailing Address - Country:US
Mailing Address - Phone:262-925-0201
Mailing Address - Fax:
Practice Address - Street 1:9916 75TH ST
Practice Address - Street 2:203
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53142-7583
Practice Address - Country:US
Practice Address - Phone:262-925-0201
Practice Address - Fax:262-925-0202
Is Sole Proprietor?:No
Enumeration Date:2014-11-04
Last Update Date:2014-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI12949-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist