WISCONSIN CVS PHARMACY LLC (NPI# 1073554945) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073554945 |
| Entity Type | Organization |
| Organization Name | WISCONSIN CVS PHARMACY LLC |
| Other Organization Name | CVS PHARMACY #08774 |
| Practice Address |
2207 80th St Kenosha WI 53143-5756 |
| Mailing Address |
1 Cvs Dr Po Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 2626583731 |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2009-11-19 |
| Authorized Official Name | CRISTIANA MAURICIO (MANAGER PHARMACY ENROLLMENTS) |
| Authorized Official Telephone | 4017702937 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 5129146 | 01 |
| Other Name | Type Code |
|---|---|
| CVS PHARMACY #08774 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508299926 | Wisconsin Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1736 W. 9th Ave., Oshkosh, WI 54902 | 2013-08-21 |
| 1194158303 | Wisconsin Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1700 Milton Ave., Janesville, WI 53545-0833 | 2013-08-12 |
| 1407298383 | Wisconsin Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2410 8th St S, Wisconsin Rapids, WI 54494-6159 | 2013-07-22 |
| 1831537869 | Wisconsin Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 102 Central Bridge St, Wausau, WI 54401-2944 | 2013-06-12 |
| 1376899120 | Wisconsin Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 4301 W Wisconsin Ave Ste 42, Appleton, WI 54913-6524 | 2012-07-31 |
| 1225398738 | Wisconsin Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 12725 W Bluemound Rd, Brookfield, WI 53005-8032 | 2012-05-18 |
| 1396014908 | Wisconsin Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | N83 W15550 Appleton Avenue, Menomonee Falls, WI 53051 | 2011-12-28 |
| 1467720037 | Wisconsin Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 6701 Mineral Point Road, Madison, WI 53705-4241 | 2011-12-09 |
| 1225305865 | Wisconsin Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 7552 W. Oklahoma Ave., West Allis, WI 53219-2860 | 2011-11-28 |
| 1952678591 | Wisconsin Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 605 W. Cottage Grove Rd., Cottage Grove, WI 53527-9222 | 2011-11-28 |
| Street Address |
2207 80TH ST |
| City | KENOSHA |
| State | WI |
| Zip Code | 53143-5756 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881229243 | Elizabeth Pereira | Pharmacist | 2207 80th St, Kenosha, WI 53143-5756 | 2020-03-05 |
| 1205461738 | Catherine Marie Avis | Pharmacist | 2207 80th St, Kenosha, WI 53143-5756 | 2020-03-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891262275 | Shanda L Goecks | Registered Nurse | 6916 26th Ave, Kenosha, WI 53143 | 2018-10-24 |
| 1689942989 | Racine Kenosha Community Action Agency | Public Health or Welfare | 2000 63rd Street, Kenosha, WI 53143 | 2011-12-01 |
| 1538497797 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 7525 Sheridan Rd, Kenosha, WI 53143 | 2009-11-30 |
| 1497929012 | Ebba M Johnson | Physical Therapist | 524 74th Street, Kenosha, WI 53143 | 2008-04-15 |
| 1770789489 | Kenosha Community Health Center, Inc | Family Medicine | 6226 14th Ave, Kenosha, WI 53143 | 2007-06-21 |
| 1558413161 | Junith M Thompson | Obstetrics & Gynecology | 6530 Sheridan Road, Kenosha, WI 53143 | 2007-01-17 |
| 1154471332 | Ljh Ambulance, Inc | Ambulance | 6329 28th Ave, Kenosha, WI 53143 | 2007-01-11 |
| 1578625794 | Michael A Schellpfeffer Md Ob Gyn Sc | Obstetrics & Gynecology | 1400 75th Street, Kenosha, WI 53143 | 2006-12-14 |
| 1457468654 | Yasmine S Sido | Physician Assistant | 7550 22nd Ave, Kenosha, WI 53143 | 2006-08-24 |
| 1356307359 | Nancy Jane Houtchens | Dentist | 7533 22nd Ave, Ste 100, Kenosha, WI 53143 | 2006-04-26 |
| Find all providers in zip 53143 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| 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: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245559301 | B7 Pharmacy Inc | Pharmacy | 9916 75th St Ste 103, Kenosha, WI 53142-7583 | 2010-05-27 |
| 1093840886 | Aurora Pharmacy, Inc | Pharmacy | 7014 Green Bay Rd, Kenosha, WI 53142-1435 | 2007-02-22 |
| 1992853253 | Roundys Supermarkets Inc | Pharmacy | 5710 75th St, Kenosha, WI 53142-3635 | 2007-01-05 |
| 1336653674 | Reliable Pharmacy of Wisconsin LLC | Pharmacy | 10105 74th St Ste 102, Kenosha, WI 53142-7519 | 2017-11-22 |
| 1407265598 | Modern Apothecary, LLC | Pharmacy | 4924 7th Ave, Kenosha, WI 53140-3349 | 2014-08-04 |
| 1659718153 | Jessica R Serpe | Pharmacy | 5300 52nd St, Kenosha, WI 53144-2310 | 2013-05-24 |
| 1841468428 | Aurora Pharmacy, Inc | Pharmacy | 2707 15th Place, Suite 101, Kenosha, WI 53140 | 2008-02-15 |
| 1326094772 | Shopko Stores Operating Co LLC | Pharmacy | 5300 52nd St, Kenosha, WI 53144-2310 | 2006-05-26 |
| 1821044744 | American Drug Stores LLC | Pharmacy | 7014 Green Bay Rd, Kenosha, WI 53142-1435 | 2006-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497355002 | Long Life Pharmacy 2 LLC | Pharmacy | 1225 W Historic Mitchell St Ste 217, Milwaukee, WI 53204-3382 | 2020-11-01 |
| 1710527783 | Sage Specialty Pharmacy Inc. | Pharmacy | 4001 N. Oakland Ave, Shorewood, WI 53211 | 2020-01-08 |
| 1790333623 | Froedtert Health Pharmacy LLC | Pharmacy | 9200 W Wisconsin Ave Ste 200w, Milwaukee, WI 53226-3522 | 2019-09-04 |
| 1225686405 | Froedtert Health Pharmacy LLC | Pharmacy | 9200 W Wisconsin Ave Ste 200c, Milwaukee, WI 53226-3522 | 2019-08-30 |
| 1134777337 | Froedtert Health Pharmacy LLC | Pharmacy | 11430 N Port Washington Rd Ste 103, Mequon, WI 53092-3414 | 2019-08-30 |
| 1619524766 | University Rx LLC | Pharmacy | 133 E College Ave, Appleton, WI 54911 | 2019-08-23 |
| 1053967026 | Accurabenefits, LLC | Pharmacy | 2413 Woodland Ter, Neenah, WI 54956-4824 | 2019-08-14 |
| 1184276917 | St. Clare Health Mission Pharmacy | Pharmacy | 916 Ferry St, La Crosse, WI 54601-4717 | 2019-07-11 |
| 1851851141 | Dean Retail Services, Inc. | Pharmacy | 740 Reena Ave Ste 300, Fort Atkinson, WI 53538-3145 | 2019-03-22 |
| 1093287237 | Del Mar Pharmacy Sc | Pharmacy | 1000 S Cesar E Chavez Dr, Milwaukee, WI 53204-2203 | 2018-12-28 |
| Find all providers with the same taxonomy | ||||
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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.