NICHOLAS STACK (NPI# 1295108967) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295108967 |
| Entity Type | Individual |
| Full Name | NICHOLAS STACK |
| Credential | B.S. IN PHARMACY |
| Practice Address |
5851 S Packard Ave Cudahy WI 53110-2615 |
| Mailing Address |
1618 S 115th Ct Apt 211 West Allis WI 53214-3785 |
| Practice Telephone | 4147446058 |
| Mailing Telephone | 4147746790 |
| Enumeration Date | 2015-11-03 |
| Last Update Date | 2015-11-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 10632-40 | WI | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | PHARMACIST LICENSE | 10632-40 | 01 |
| Street Address |
5851 S PACKARD AVE |
| City | CUDAHY |
| State | WI |
| Zip Code | 53110-2615 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174778120 | Roundys Supermarkets Inc | Pharmacy | 5851 S Packard Ave, Cudahy, WI 53110-2615 | 2008-11-18 |
| 1659778710 | Harold Krueger | Pharmacist | 5851 S Packard Ave, Cudahy, WI 53110-2615 | 2014-12-04 |
| 1033515044 | Yousef Hasan | Pharmacist | 5851 S Packard Ave, Cudahy, WI 53110-2615 | 2014-11-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164059150 | Access Mobility Vans, Inc. | Durable Medical Equipment & Medical Supplies | 1995 E. Norse Ave., Cudahy, WI 53110 | 2020-03-27 |
| 1497191357 | Kristel Roebbeke | Occupational Therapist | 4157 W College Ave, Milwaukee, WI 53110 | 2013-05-20 |
| 1568684058 | City of Cudahy | Case Management | 5050 South Lake Drive, Cudahy, WI 53110 | 2007-05-03 |
| 1104854363 | Mathew George Mathai | Internal Medicine | 5900 S. Lake Dr., Cudahy, WI 53110 | 2006-06-28 |
| 1174917199 | Alyssa Kaleta | Internal Medicine | 5900 S Lake Dr, Cudahy, WI 53110 | 2015-03-27 |
| 1740546829 | Fatima Ali | Family Medicine | 5900 S Lake Dr, Cudahy, WI 53110 | 2012-04-03 |
| 1609003508 | Elizabeth A Vissat | Podiatrist | 5900 S Lake Dr, 2 West, Cudahy, WI 53110 | 2009-06-18 |
| 1366616864 | Miguel A Aguilera | Anesthesiology | 5900 S Lake Dr, Cudahy, WI 53110 | 2008-04-15 |
| 1235355983 | Aurora Health Care Metro, Inc. | Clinic/Center | 5900 S Lake Drive, Cudahy, WI 53110 | 2007-04-18 |
| 1114005618 | Manila Sodhi | Internal Medicine | 5900 S Lake Dr, 2 West, Cudahy, WI 53110 | 2006-11-01 |
| Find all providers in zip 53110 | ||||
| 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 |
|---|---|---|---|---|
| 1053698944 | Saroja Sunkara | Pharmacist | 3021 E Layton Ave, Cudahy, WI 53110-1307 | 2011-11-07 |
| 1528380391 | Karen Sostarich | Pharmacist | 6077 S Packard Ave, Cudahy, WI 53110-3027 | 2010-02-22 |
| 1437360450 | Victor Petrovs | Pharmacist | 3828 E Iona Ter, Cudahy, WI 53110-2720 | 2007-05-24 |
| 1780715284 | Rick Anthony Michalski | Pharmacist | 4525 S Lawler Ave, Cudahy, WI 53110-1223 | 2007-03-08 |
| 1255966610 | Anna Victoria Meier | Pharmacist | 5740 S Packard Ave, Cudahy, WI 53110-2659 | 2020-03-05 |
| 1225663685 | Yousra Abuasi | Pharmacist | 5740 S Packard Ave, Cudahy, WI 53110-2659 | 2020-03-05 |
| 1417580036 | Rachel Quentin | Pharmacist | 6241 S Packard Ave, Cudahy, WI 53110-3031 | 2020-02-21 |
| 1689239774 | Aaron Guorong Xie | Pharmacist | 7825 Atlantic Ave, Cudahy, CA 90201-5022 | 2019-05-05 |
| 1538607619 | Loan Vong | Pharmacist | 7825 Atlantic Ave, Cudahy, CA 90201-5022 | 2017-02-08 |
| 1518405612 | Kari Truong | Pharmacist | 7825 Atlantic Ave, Cudahy, CA 90201-5022 | 2017-02-08 |
| Find all providers in CUDAHY | ||||
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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.