Basic Information
| Provider Information | |||||||||
| NPI: | 1174811152 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BAYER | ||||||||
| FirstName: | JOSHUA | ||||||||
| MiddleName: | BRIAN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PHARMD, BCPS, AAHIVP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5000 W NATIONAL AVE | ||||||||
| Address2: | |||||||||
| City: | MILWAUKEE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 532950001 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 4000 STATE ROAD 16 | ||||||||
| Address2: | |||||||||
| City: | LA CROSSE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 546011809 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6087843886 | ||||||||
| FaxNumber: | 6083721106 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2011 | ||||||||
| LastUpdateDate: | 05/10/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1835P1200X | PHA.0018456 | CO | Y | Pharmacy Service Providers | Pharmacist | Pharmacotherapy |
No ID Information.