METHODIST MANOR HEALTH CENTER, INC. (NPI# 1073580403) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073580403 |
| Entity Type | Organization |
| Organization Name | METHODIST MANOR HEALTH CENTER, INC. |
| Other Organization Name | MANOR PHARMACY |
| Practice Address |
8615 W Beloit Rd West Allis WI 53227-3711 |
| Mailing Address |
3023 S 84th St West Allis WI 53227-3703 |
| Practice Telephone | 4146072165 |
| Practice Fax Number | 4146074507 |
| Mailing Telephone | 4146074100 |
| Mailing Fax Number | 4146074502 |
| Enumeration Date | 2006-03-03 |
| Last Update Date | 2009-04-08 |
| Authorized Official Name | MR. JAMES ENLUND (PRESIDENT & CEO) |
| Authorized Official Telephone | 4146074100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | 6309 | WI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | STATE LICENSE NUMBER | 6309 | 01 |
| WI | DEA NUMBER | AM1036739 | 01 |
| WI | 33028500 | 05 | |
| WI | NCPDP NUMBER | 5116187 | 01 |
| Other Name | Type Code |
|---|---|
| Manor Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538136254 | Methodist Manor Health Center, Inc. | Family Medicine | 8520 W Oklahoma Ave, West Allis, WI 53227-4604 | 2006-03-01 |
| 1518934264 | Methodist Manor Health Center, Inc. | Pharmacy | 7300 W Dean Rd, Milwaukee, WI 53223-2637 | 2006-03-01 |
| Street Address |
8615 W BELOIT RD |
| City | WEST ALLIS |
| State | WI |
| Zip Code | 53227-3711 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194992529 | Helen Mary Fliss | Occupational Therapist | 8615 W Beloit Rd, West Allis, WI 53227-3711 | 2008-05-14 |
| 1467581595 | Aurora Pharmacy, Inc. | Pharmacy | 8615 W Beloit Rd, West Allis, WI 53227-3711 | 2007-03-05 |
| 1134196983 | Methodist Manor Health Center Inc | Alzheimer Center (Dementia Center) | 8615 W Beloit Rd, West Allis, WI 53227-3711 | 2006-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205451564 | Ginger Renee Bland | Nurse Practitioner | 11133 W. National Avenue, West Allis, WI 53227 | 2020-06-12 |
| 1003312141 | Dynamic Medical Equipment, LLC | Durable Medical Equipment & Medical Supplies | 10236 W National Ave, West Allis, WI 53227 | 2018-04-05 |
| 1932572641 | Alissa Kristine Walker | Specialist/Technologist | 11601 W Lincoln Ave, West Allis, WI 53227 | 2015-11-03 |
| 1396155990 | Bradly Earl Helinski | Physical Therapy Assistant | 3023 S 84th St., Milwaukee, WI 53227 | 2014-05-05 |
| 1609299783 | Amy Renee Rozumalski | Occupational Therapy Assistant | 10150 W. National Ave, Suite 150, Premiere Medical Staffing Services, LLC, Milwaukee, WI 53227 | 2014-01-27 |
| 1497098438 | Kathleen Marie Schneider | Physical Therapy Assistant | 3023 S. 84th Street, Milwaukee, WI 53227 | 2013-03-28 |
| 1760723373 | Lee Ann Schraith | Physical Therapy Assistant | 3023 S. 84th St, Milwaukee, WI 53227 | 2013-03-06 |
| 1740520725 | Samantha Lynn Wozniak | Physical Therapist | 3023 S. 84th St., Milwaukee, WI 53227 | 2013-02-27 |
| 1831434901 | Andrew Paul Roeder | Physical Therapy Assistant | 3023 S. 89th Street, Milwaukee, WI 53227 | 2012-11-30 |
| 1538418116 | Christine Wilford | Social Worker | 2044 S 96th Street, West Allis, WI 53227 | 2012-08-29 |
| Find all providers in zip 53227 | ||||
| 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 |
|---|---|---|---|---|
| 1891148318 | West Allis Prescription Center Inc | Pharmacy | 6737 W Washington Ave, Suite 1100, West Allis, WI 53214 | 2016-07-20 |
| 1467581595 | Aurora Pharmacy, Inc. | Pharmacy | 8615 W Beloit Rd, West Allis, WI 53227-3711 | 2007-03-05 |
| 1164509949 | Good Value Pharmacy LLC | Pharmacy | 10233 W Greenfield Ave, West Allis, WI 53214-3911 | 2006-11-01 |
| 1770514812 | K Mart Corp | Pharmacy | 6900 W Greenfield Ave, West Allis, WI 53214-4849 | 2006-07-06 |
| 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 | ||||
| City | WEST ALLIS |
| Zip Code | 53227 |
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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.