Most Relevant Information
Provider Data
| NPI Number: | 1003575598 |
| Provider Name: | DEREK KOLAGA |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 21156-40 |
Most Important Dates
| Enumeration Date: | 12/11/2021 |
| Last Updated: | 12/11/2021 |
Provider Practice Location
351 S WASHBURN ST
OSHKOSH
WI
549047932
Practice Location Phone/Fax
| Phone: | 9202312219 |
| Fax: |
Provider Mailing Location
W2183 STATE ROAD 33
MAYVILLE
WI
530502601
Provider Mailing Phone/Fax
| Phone: | 9205571863 |
| Fax: |