OrganizationActive
13th Street Pharmacy LLC
NPI 1679835326 · Community/Retail Pharmacy · Milwaukee, WI
Provider details
- NPI number
- 1679835326
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Russel Shtivelberg, Member(414) 324-9393
- License
- 9131-42 (WI)
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(79/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1320 W Burnham St
Milwaukee, WI 53204-3248
Phone: (414) 383-4111
Fax: (414) 383-2248
Street-level locationGet directions
Mailing address
1320 W Burnham St
Milwaukee, WI 53204-3248
Other names (DBA / former)
- Doing business as
- 13th Street Pharmacy LLC
Registry dates
- Enumerated
- 2012-06-08
- Last updated
- 2014-12-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.