Most Relevant Information
Provider Data
| NPI Number: | 1003414822 |
| Provider Name: | MICHAEL GREMBAN |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 17947-40 |
Most Important Dates
| Enumeration Date: | 10/14/2020 |
| Last Updated: | 10/14/2020 |
Provider Practice Location
4140 W GREENFIELD AVE
WEST MILWAUKEE
WI
532151334
Practice Location Phone/Fax
| Phone: | 4149782007 |
| Fax: | 4149782008 |
Provider Mailing Location
106 WOODLARK CT
WAUKESHA
WI
531861257
Provider Mailing Phone/Fax
| Phone: | 9202654571 |
| Fax: |