KIMBERLY HOMETOWN PHARMACY LLC (NPI# 1295291045) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295291045 |
| Entity Type | Organization |
| Organization Name | KIMBERLY HOMETOWN PHARMACY LLC |
| Practice Address |
W2721 Brookhaven Dr Appleton WI 54915-8184 |
| Mailing Address |
333 Lowville Rd Rio WI 53960-9437 |
| Practice Telephone | 9204233438 |
| Practice Fax Number | 9204233489 |
| Mailing Telephone | 9209926800 |
| Mailing Fax Number | 9209926801 |
| Enumeration Date | 2019-02-18 |
| Last Update Date | 2019-04-04 |
| Authorized Official Name | DIANE DEANS (CONTRACTING SPECIALIST) |
| Authorized Official Telephone | 9209926800 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| Street Address |
W2721 BROOKHAVEN DR |
| City | APPLETON |
| State | WI |
| Zip Code | 54915-8184 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972944825 | Jennifer Baerenwald | Pharmacist | W2721 Brookhaven Dr, Appleton, WI 54915-8184 | 2013-07-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205466737 | Leyes Robers Dental LLC | Dentist | 3216 W County Rd Kk, Appleton, WI 54915 | 2020-01-23 |
| 1912426958 | Shanna L. Larsen | Registered Nurse | 1101 E. South River St., Appleton, WI 54915 | 2017-09-11 |
| 1477082816 | Amy Fazel | Driver | 226 E Calumet St, Appleton, WI 54915 | 2017-06-08 |
| 1871940213 | B.a.israel LLC | Community Based Residential Treatment Facility, Mental Illness | N9520 Silver Court, Appleton, WI 54915 | 2016-05-16 |
| 1982933479 | Stephanie I. Braski | Counselor | 1531 S. Oneida St, Appleton, WI 54915 | 2009-12-14 |
| 1386808319 | Shawn S Williamson | Emergency Medicine | 1506 South Oneida Street, Appleton, WI 54915 | 2008-07-18 |
| 1700040870 | Heidi Jo Van Toll | Occupational Therapist | 1335 S Oneida Street, Appleton, WI 54915 | 2008-07-17 |
| 1669639142 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | N9642 County Rd N, Appleton, WI 54915 | 2008-05-21 |
| 1265699748 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | 1531 S Madison St Fl 4, Appleton, WI 54915 | 2008-05-21 |
| 1073770558 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | 1531 S Madison St Ste 580, Appleton, WI 54915 | 2008-05-21 |
| Find all providers in zip 54915 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| 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: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427514504 | Northland Hometown Pharmacy LLC | Pharmacy | 420 E Northland Ave Ste H, Appleton, WI 54911-2159 | 2019-02-14 |
| 1528395522 | Roundys Supermarkets Inc | Pharmacy | 511 W Calumet St, Appleton, WI 54915-1462 | 2009-11-11 |
| 1053645986 | Morton Drug Co Inc | Pharmacy | 2500 E Capitol Dr Ste 1500, Appleton, WI 54911-8735 | 2009-09-24 |
| 1851529101 | Walgreen Co | Pharmacy | 2803 N Meade St, Appleton, WI 54911-1507 | 2009-06-25 |
| 1487895108 | Roundys Supermarkets Inc | Pharmacy | 2700 N Ballard Rd, Appleton, WI 54911-8657 | 2009-03-09 |
| 1487661302 | Walgreen Co | Pharmacy | 1901 S Oneida St, Appleton, WI 54915-1834 | 2006-08-02 |
| 1376565077 | Wisconsin Cvs Pharmacy LLC | Pharmacy | 1800 S Kensington Dr, Appleton, WI 54915-4136 | 2006-07-24 |
| 1851325070 | Aurora Pharmacy Inc | Pharmacy | 1919 E Calumet St, Appleton, WI 54915-4741 | 2006-07-11 |
| 1679507891 | Aurora Pharmacy Inc | Pharmacy | 2400 W Wisconsin Ave, Appleton, WI 54914-3109 | 2006-07-11 |
| 1619918588 | Wisconsin Cvs Pharmacy LLC | Pharmacy | 700 W Wisconsin Ave, Appleton, WI 54914-3567 | 2006-06-09 |
| Find all providers in APPLETON | ||||
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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.