WISCONSIN CVS PHARMACY LLC (NPI# 1124235916) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124235916 |
| Entity Type | Organization |
| Organization Name | WISCONSIN CVS PHARMACY LLC |
| Other Organization Name | CVS PHARMACY #16450 |
| Practice Address |
4301 Lien Rd Madison WI 53704-3608 |
| Mailing Address |
1 Cvs Dr Mail Code 1090 Woonsocket RI 02895-6146 |
| Practice Telephone | 6088191911 |
| Practice Fax Number | 6083275671 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2016-12-13 |
| Authorized Official Name | SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS) |
| Authorized Official Telephone | 4017702751 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
8749042 | WI | Suppliers |
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2111038 | 01 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #16450 | 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 |
4301 LIEN RD |
| City | MADISON |
| State | WI |
| Zip Code | 53704-3608 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437772563 | Gloria H Liao | Pharmacist | 4301 Lien Rd, Madison, WI 53704-3608 | 2020-05-22 |
| 1275160483 | Adam Doebert | Pharmacist | 4301 Lien Rd, Madison, WI 53704-3608 | 2020-03-26 |
| 1992256986 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 4301 Lien Rd, Madison, WI 53704-3608 | 2016-10-14 |
| 1467748129 | Annie Baeten | Pharmacist | 4301 Lien Rd, T-1069, Madison, WI 53704-3608 | 2011-06-21 |
| 1336435130 | Tamela Lee Seabourne | Pharmacist | 4301 Lien Rd, Madison, WI 53704-3608 | 2011-06-21 |
| 1114157427 | Midline Vision Clinics Sc | Optometrist | 4301 Lien Rd, Madison, WI 53704 | 2009-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407369614 | Joseph Michael Oakley II | Chiropractor | 2801 International Ln Ste 102, Madison, WI 53704 | 2017-11-09 |
| 1972015048 | Suzanne Lee | Psychiatry & Neurology | 1835 Winnebago St. #402, Madison, WI 53704 | 2017-10-30 |
| 1831554021 | Gideon Kazah | Licensed Practical Nurse | 2488 Dahle Street, Madison, WI 53704 | 2015-12-15 |
| 1174952220 | Group Health Cooperative of South Central Wisconsin Madison College | Durable Medical Equipment & Medical Supplies | 1705 Hoffman Street, Madison, WI 53704 | 2013-11-08 |
| 1407190127 | Ashley Marie Snyder | Social Worker | 5203 Autumn Leaf Lane, Apt. 389, Madison, WI 53704 | 2012-11-19 |
| 1619230638 | Dawn Lynette Butts | Optometrist | 4208 E Washington Ave, Madison, WI 53704 | 2012-06-25 |
| 1679865992 | Sharon Kelley | Psychologist | 1213 N. Sherman Ave, Suite 334, Madison, WI 53704 | 2011-05-04 |
| 1578730412 | St. Charles Youth & Family Services | Community Based Residential Treatment Facility, Mental Illness | 310 Troy Dr, Cottage B, Madison, WI 53704 | 2008-05-09 |
| 1538346960 | Elizabeth Ann Reiser-loeber | Dentist | 1001 N. Sherman Ave, Madison, WI 53704 | 2008-01-28 |
| 1861683088 | Stephen Dale Flach | Internal Medicine | Covance, 3402 Kinsman Blvd, Madison, WI 53704 | 2007-08-05 |
| Find all providers in zip 53704 | ||||
| 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 |
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| 1013368216 | Kroger Limited Partnership I | Pharmacy | 4579 Wall Triana Hwy, Madison, AL 35758-9305 | 2016-06-29 |
| 1740636786 | Mississippi Center for Advanced Medicine PC | Pharmacy | 7731 Old Canton Rd Ste B, Madison, MS 39110-6115 | 2016-05-09 |
| 1588077325 | Madison Pharmacy Inc. | Pharmacy | 8498 Madison Blvd Ste A, Madison, AL 35758-2049 | 2014-06-10 |
| 1831419688 | Gluckstadt Special Care Pharmacy & Compounding | Pharmacy | 1716 Highway 51, Suite N, Madison, MS 39110-5020 | 2010-06-03 |
| 1013169598 | Willow Pharmacy Inc | Pharmacy | 2445 Darwin Rd, Suite 102, Madison, WI 53704-3116 | 2008-10-16 |
| 1790821312 | Skj Inc | Pharmacy | 217 Cottage Grove Rd, Madison, WI 53716-1105 | 2007-01-30 |
| 1114075777 | Roundys Supermarkets Inc | Pharmacy | 2502 Shopko Dr, Madison, WI 53704-4119 | 2007-01-08 |
| 1134205008 | Moore Health Inc. | Pharmacy | 1400 Eatonton Rd, Suite 600, Madison, GA 30650-4642 | 2006-10-31 |
| 1265521884 | Lewis Drugs Inc | Pharmacy | 741 S Washington Ave, Madison, SD 57042-3409 | 2006-10-12 |
| 1780772236 | University of Wisconsin Hospitals & Clinics Authority | Pharmacy | 702 N Midvale Blvd, Suite 168, Madison, WI 53705-3261 | 2006-10-10 |
| Find all providers in MADISON | ||||
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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.