THEDACARE MEDICAL CENTER - WAUPACA, INC. (NPI# 1063837557) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063837557 |
| Entity Type | Organization |
| Organization Name | THEDACARE MEDICAL CENTER - WAUPACA, INC. |
| Other Organization Name | RIVERSIDE MEDICAL CENTER, INC. |
| Practice Address |
6501 City West Pkwy Eden Prairie MN 55344-3248 |
| Practice Telephone | 9526532525 |
| Mailing Telephone | 9526532525 |
| Enumeration Date | 2014-02-20 |
| Last Update Date | 2015-07-17 |
| Authorized Official Name | DWAYNE RIENDEAU (PHARMACIST) |
| Authorized Official Telephone | 7152581000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | Suppliers |
| Other Name | Type Code |
|---|---|
| Riverside Medical Center, Inc. | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710333893 | Thedacare Medical Center - Waupaca, Inc. | General Acute Care Hospital | N2610 Wi 22, Waupaca, WI 54981 | 2016-05-09 |
| 1992110399 | Thedacare Medical Center - Waupaca, Inc. | Clinical Medical Laboratory | 800 Riverside Dr, Waupaca, WI 54981-1943 | 2014-06-24 |
| 1073799664 | Thedacare Medical Center - Waupaca, Inc. | General Acute Care Hospital | 800 Riverside Dr, Waupaca, WI 54981-1943 | 2008-01-14 |
| 1780782680 | Thedacare Medical Center - Waupaca, Inc. | Nurse Anesthetist, Certified Registered | 800 Riverside Dr, Waupaca, WI 54981-1943 | 2006-09-21 |
| 1831131796 | Thedacare Medical Center - Waupaca, Inc. | Medicare Defined Swing Bed Unit | 800 Riverside Dr, Waupaca, WI 54981-1943 | 2006-06-12 |
| 1013995521 | Thedacare Medical Center - Waupaca, Inc. | General Acute Care Hospital | 800 Riverside Dr, Waupaca, WI 54981-1943 | 2006-01-04 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | THEDACARE MEDICAL CENTER - WAUPACA, INC. | 800 Riverside Dr, Waupaca, WI 54981-1943 |
| Street Address |
6501 CITY WEST PKWY |
| City | EDEN PRAIRIE |
| State | MN |
| Zip Code | 55344-3248 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184798605 | Redpharm Drug, Inc. | Pharmacy | 6501 City West Pkwy, Eden Prairie, MN 55344-3248 | 2006-11-17 |
| 1245539832 | Instymeds Corporation | Non-Pharmacy Dispensing Site | 6501 City West Pkwy, Eden Prairie, MN 55344-3248 | 2011-03-22 |
| 1710206636 | Thedacare Medical Center - Shawano, Inc. | Non-Pharmacy Dispensing Site | 6501 City West Pkwy, Eden Prairie, MN 55344-3248 | 2010-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366000572 | Hekima Care Inc. | Case Management | 8725 Columbine Rd Unit 46026, Eden Prairie, MN 55344 | 2019-06-03 |
| 1528537768 | Smile Eden Prairie | Dentist | 6600 City W. Pkwy #315, Eden Prairie, MN 55344 | 2018-11-16 |
| 1215439781 | Angelo Scherer | Counselor | 11010 Prairie Lakes Drive Suite 350, Eden Prairie, MN 55344 | 2018-03-01 |
| 1497272678 | Matthew Lynn | Occupational Therapist | 431 Prairie Center Drive, Eden Prairie, MN 55344 | 2017-08-28 |
| 1184178956 | Eric R Barrett | Audiologist | Starkey Center for Excellence, 6700 Washington Ave S, Eden Prairie, MN 55344 | 2016-08-10 |
| 1609218676 | Nations Care Link | Nurse Practitioner | 11000 Praire Lakes Dr, Suite 600, Eden Praire, MN 55344 | 2013-07-19 |
| 1497020390 | Alixa Rx LLC | Pharmacy | 10132 West 76th St, Eden Prairie, MN 55344 | 2012-03-12 |
| 1831467331 | Eagle Ridge Academy | Local Education Agency (LEA) | 7255 Flying Cloud Drive, Eden Prairie, MN 55344 | 2011-12-12 |
| 1205154739 | Eden Prairie School District 272 | Local Education Agency (LEA) | 8100 School Road, Eden Prairie, MN 55344 | 2010-05-07 |
| 1992030613 | Spinal Health | Chiropractor | 12100 Singletree Ln #129, Eden Prairie, MN 55344 | 2009-10-14 |
| Find all providers in zip 55344 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245539832 | Instymeds Corporation | Non-Pharmacy Dispensing Site | 6501 City West Pkwy, Eden Prairie, MN 55344-3248 | 2011-03-22 |
| 1710206636 | Thedacare Medical Center - Shawano, Inc. | Non-Pharmacy Dispensing Site | 6501 City West Pkwy, Eden Prairie, MN 55344-3248 | 2010-05-18 |
| 1487891768 | Fairview Eden Center Mtm | Non-Pharmacy Dispensing Site | 830 Prairie Center Dr, Eden Prairie, MN 55344-7301 | 2009-01-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518528397 | Fairview Pharmacy Services LLC | Non-Pharmacy Dispensing Site | Fairview Lakeville Clinic Mtm, 18580 Joplin Ave, Lakeville, MN 55044 | 2019-06-24 |
| 1851856504 | Tareen Dermatology, Pa | Non-Pharmacy Dispensing Site | 2945 Hazelwood St Ste 230, Maplewood, MN 55109-1241 | 2019-02-07 |
| 1417450651 | Cerner Health Connections, Inc | Non-Pharmacy Dispensing Site | 4001 Lexington Ave N Ste C2-435, Arden Hills, MN 55126-2934 | 2018-03-14 |
| 1316461593 | Fairview Pharmacy Service LLC | Non-Pharmacy Dispensing Site | 7250 France Ave S Ste 410, Edina, MN 55435-4314 | 2017-07-31 |
| 1346653052 | Advanced Spine and Pain Clinics of Mn, LLC | Non-Pharmacy Dispensing Site | 308 Brighton Ave, Suite D, Buffalo, MN 55313-2303 | 2014-06-10 |
| 1407296148 | Group Health Plan Inc | Non-Pharmacy Dispensing Site | 1833 2nd Ave, Anoka, MN 55303-2432 | 2013-06-26 |
| 1295178135 | Fairview Pharmacy Services LLC | Non-Pharmacy Dispensing Site | 6440 Nicollet Ave South, Richfield, MN 55423-1613 | 2013-04-10 |
| 1992148845 | Fairview Pharmacy Services LLC | Non-Pharmacy Dispensing Site | 2450 Riverside Ave South, Minneapolis, MN 55454-1400 | 2013-04-10 |
| 1083984876 | Mayo Clinic Health System-southeast Minnesota Region | Non-Pharmacy Dispensing Site | 32021 County 24 Boulevard, Cannon Falls, MN 55009-1824 | 2012-01-10 |
| 1255623765 | Mankato Clinic, Ltd | Non-Pharmacy Dispensing Site | 305 Main St Ne, Mapleton, MN 56065 | 2011-05-03 |
| Find all providers with the same taxonomy | ||||
| City | EDEN PRAIRIE |
| Zip Code | 55344 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.