MR. JOHN HERBERT WAGNER (NPI# 1235524075) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235524075 |
| Entity Type | Individual |
| Full Name | MR. JOHN HERBERT WAGNER |
| Credential | R. PH. |
| Practice Address |
3900 Erie St Racine WI 53402-3544 |
| Practice Telephone | 2626391611 |
| Practice Fax Number | 2626395611 |
| Mailing Telephone | 2626391611 |
| Mailing Fax Number | 2626395611 |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2015-03-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 8002-40 | WI | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | NPI | 1225062441 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861802498 | John M. Wagner | Counselor | 1048 Sumac St, Longmont, CO 80501-4146 | 2014-05-05 |
| 1326323221 | John Wagner | Physical Therapist | 3079 Nestall Rd, Laguna Beach, CA 92651-2026 | 2011-10-12 |
| 1821384728 | John C Wagner | Pharmacist | 1703 Elm St W, Hampton, SC 29924 | 2011-06-20 |
| 1033320577 | John Wagner | Psychiatry & Neurology | 7330 Fern Ave Ste 704, Shreveport, LA 71105-4985 | 2007-05-25 |
| 1013044197 | John Daniel Wagner | Massage Therapist | 2315 N Pearl St Ste 10, Pmb 188, Tacoma, WA 98406-2553 | 2007-02-27 |
| 1588719066 | John J Wagner | Psychologist | 7374 Reading Rd Ste 110, Cincinnati, OH 45237-3409 | 2007-01-24 |
| 1033262340 | John D Wagner | Internal Medicine | 451 Clarkson Ave Rm B-1147, Kings County Hospital Center, Brooklyn, NY 11203-2054 | 2007-01-19 |
| 1942316385 | John Otto Wagner | Legal Medicine | 1950 Stanley Rd Bldg 2376, San Antonio Military Entrance Processing Station, Fort Sam Houston, TX 78234-7547 | 2006-08-21 |
| 1881635159 | John Adam Wagner | Chiropractor | 411 Hyde Park, Doylestown, PA 18902-6619 | 2006-06-09 |
| 1386697019 | John Wagner | Specialist/Technologist | 35 Colgate St, Jersey City, NJ 07302-3307 | 2006-05-17 |
| Street Address |
3900 ERIE ST |
| City | RACINE |
| State | WI |
| Zip Code | 53402-3544 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225062441 | Aurora Pharmacy Inc | Pharmacy | 3900 Erie St, Suite 100, Racine, WI 53402-3544 | 2006-07-11 |
| 1013426949 | Racine Hometown Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3900 Erie St, Racine, WI 53402-3544 | 2017-09-22 |
| 1093113250 | Jill Van Order Gates | Pharmacist | 3900 Erie St, Racine, WI 53402-3544 | 2014-12-19 |
| 1932538881 | Richard Dvorsky | Pharmacist | 3900 Erie St, Racine, WI 53402-3544 | 2013-11-01 |
| 1205943990 | Susan H Ward | Nurse Practitioner | 3900 Erie St, Racine, WI 53402-3544 | 2006-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215586847 | Jennifer Ann Wagener | Technician | 1513 Melvin Ave, Racine, WI 53402 | 2019-09-06 |
| 1023530490 | Tahir Vora | Pharmacist | 6840 Middle Rd Apt 8, Racine, WI 53402 | 2017-07-07 |
| 1154852069 | Golden Path Services | Home Health | 1700 North Main Street, Upper, Racine, WI 53402 | 2017-03-22 |
| 1376842690 | Vashir Jim Xiong | Acupuncturist | 3726 Ruby Ave, Racine, WI 53402 | 2011-03-25 |
| 1215248927 | Andrew M Asbury | Family Medicine | 2408 Four Mile Rd, Racine, WI 53402 | 2010-06-28 |
| 1215058532 | Lakeshore Family Dental Care Sc | Dentist | 3903 Douglas Ave, Racine, WI 53402 | 2007-04-03 |
| 1679626915 | David Ramon Reesman | Dentist | 3900 North Bay Dr, Racine, WI 53402 | 2007-01-19 |
| 1639286958 | Mary E Pagano | Internal Medicine | 5333 Douglas Ave, Racine, WI 53402 | 2006-08-23 |
| 1881605111 | Caledonia Chiropractic Clinic, Sc | Chiropractor | 5401 Douglas Ave, Suite A, Racine, WI 53402 | 2006-08-11 |
| 1003923996 | David C Zablotney | Family Medicine | 5333 Douglas Ave, Racine, WI 53402 | 2006-08-24 |
| Find all providers in zip 53402 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578164349 | Lynn Huynh | Pharmacist | 5695 Washington Ave, Racine, WI 53406 | 2020-11-06 |
| 1174930358 | Craig John Borgardt | Pharmacist | 6520 Hidden Creek Rd, Racine, WI 53402-9403 | 2014-07-19 |
| 1184038655 | Sunday Muniz | Pharmacist | 5220 Washington Ave, Ste 101, Racine, WI 53406-4228 | 2014-06-12 |
| 1033486592 | Paul Byron Anthony | Pharmacist | 5104 Cortland Ave, Racine, WI 53406 | 2011-11-28 |
| 1407132194 | John Thomas Keil | Pharmacist | 116 Northwood Dr, Racine, WI 53402-1938 | 2011-10-26 |
| 1982926507 | Mark Edward Buhler | Pharmacist | 2211 S Green Bay Rd, Racine, WI 53406-4919 | 2010-02-23 |
| 1033115787 | Mark A. Pelton | Pharmacist | 3801 Spring St, Racine, WI 53405-1667 | 2005-06-27 |
| 1144855008 | Jason Slaasted | Pharmacist | 4810 Washington Ave, Racine, WI 53406-4220 | 2020-03-11 |
| 1780218941 | Nicholas Kuroski | Pharmacist | 4810 Washington Ave, Racine, WI 53406-4220 | 2020-02-26 |
| 1871127407 | Ngan T Le | Pharmacist | 1920 Douglas Ave, Racine, WI 53402-4614 | 2020-02-22 |
| Find all providers in RACINE | ||||
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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.