WISCONSIN CVS PHARMACY LLC (NPI# 1255372124) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255372124 |
| Entity Type | Organization |
| Organization Name | WISCONSIN CVS PHARMACY LLC |
| Other Organization Name | CVS PHARMACY |
| Practice Address |
1122 West Blvd Racine WI 53405-3020 |
| Mailing Address |
1 Cvs Dr Po Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 2626375603 |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2008-02-27 |
| 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 | 5129122 | 01 |
| Other Name | Type Code |
|---|---|
| CVS PHARMACY | 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 |
1122 WEST BLVD |
| City | RACINE |
| State | WI |
| Zip Code | 53405-3020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609407923 | Anita Kathy Nykaza | Dietitian, Registered | 3805 A Suite 311, Racine, WI 53405 | 2020-01-27 |
| 1023666062 | Shawn L Drulia | Physician Assistant | 3805 Spring St #320, Racine, WI 53405 | 2019-09-03 |
| 1235627720 | Oxygen One, Inc. | Durable Medical Equipment & Medical Supplies | 3805a Spring Street, Suite 210, Racine, WI 53405 | 2018-04-30 |
| 1356838650 | Melissa Metzger | Psychologist | 2340 Mohr Ave, Racine, WI 53405 | 2018-04-23 |
| 1689029217 | Melissa Ileen Swainston | Nurse Practitioner | 3803 Spring St., Suite Number 410, Racine, WI 53405 | 2016-05-02 |
| 1215305487 | Denetta Lauraelaine Flowers | Licensed Practical Nurse | 4311 Durand Ave., #104, Mt.pleasant, WI 53405 | 2015-09-04 |
| 1841675204 | Colleen Koderca | Registered Nurse | 3317-meachem Rd, Racine, WI 53405 | 2015-07-28 |
| 1790102986 | Georges Wakim | Specialist/Technologist | 3811 Spring St., Suite 102, Racine, WI 53405 | 2014-03-25 |
| 1982021176 | Matthew F Patzke | Specialist/Technologist | 3811 Spring Street Suite 102, Racine, WI 53405 | 2014-03-25 |
| 1073930269 | Jessica Geisler | Specialist/Technologist | 3811 Spring Street Suite #102, Racine, WI 53405 | 2014-03-25 |
| Find all providers in zip 53405 | ||||
| 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 |
|---|---|---|---|---|
| 1912019837 | Nutritional Designs LLC | Pharmacy | 5220 Washington Ave Ste 101, Racine, WI 53406-4228 | 2006-08-31 |
| 1285680793 | Jewel Food Stores Inc | Pharmacy | 5740 Washington Ave, Racine, WI 53406-4018 | 2006-05-26 |
| 1154325199 | Lakeview Pharmacy of Racine Inc | Pharmacy | 516 Monument Sq, Racine, WI 53403-1033 | 2005-06-08 |
| 1063416097 | Lakeview Pharmacy of Racine Inc | Pharmacy | 517 Wisconsin Ave, Racine, WI 53403-1050 | 2005-06-08 |
| 1902931702 | Aurora Pharmacy, Inc. | Pharmacy | 5740 Washington Ave, Racine, WI 53406-4018 | 2007-02-22 |
| 1790878122 | Ascension All Saints Hospital, Inc | Pharmacy | 1244 Wisconsin Ave, Racine, WI 53403-1987 | 2006-09-30 |
| 1407887540 | K Mart Corp | Pharmacy | 2211 S Green Bay Rd, Racine, WI 53406-4919 | 2006-07-06 |
| 1174579528 | Shopko Stores Operating Co LLC | Pharmacy | 4801 Washington Ave, Racine, WI 53406-4219 | 2006-05-26 |
| 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.