RELIABLE PHARMACY OF WISCONSIN LLC (NPI# 1336653674) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336653674 |
| Entity Type | Organization |
| Organization Name | RELIABLE PHARMACY OF WISCONSIN LLC |
| Other Organization Name | RELIABLE PHARMACY OF WISCONSIN |
| Practice Address |
10105 74th St Ste 102 Kenosha WI 53142-7519 |
| Mailing Address |
10105 74th St Suite 102 Kenosha WI 53142-7519 |
| Practice Telephone | 2629095685 |
| Practice Fax Number | 2629258409 |
| Mailing Telephone | 2629095685 |
| Mailing Fax Number | 2629258409 |
| Enumeration Date | 2017-11-22 |
| Last Update Date | 2018-07-19 |
| Authorized Official Name | CYNTHIA CERNAK (OWNER) |
| Authorized Official Telephone | 2625656353 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
9488-42 | WI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 100073905 | 05 | |
| PK | 2172877 | 01 |
| Other Name | Type Code |
|---|---|
| Reliable Pharmacy of Wisconsin | Doing Business As Name - Organization |
| Street Address |
10105 74TH ST STE 102 |
| City | KENOSHA |
| State | WI |
| Zip Code | 53142-7519 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649259128 | Devinder K Sidhu | Anesthesiology | 10105 74th St Ste 102, Kenosha, WI 53142-7519 | 2006-01-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588297816 | Caring Hearts Home Health Care | In Home Supportive Care | 6021-57th Ave, Suite C103, Kenosha, WI 53142 | 2020-02-14 |
| 1144785395 | Michael L Wrzesinski | Counselor | 4109 67th Street, Kenosha, WI 53142 | 2019-02-01 |
| 1720538499 | David Smith | Counselor | 10900 67th Street, Kenosha, WI 53142 | 2016-10-06 |
| 1326404641 | Smile Doctors Ltd | Dentist | 7003 39th Ave, Kenosha, WI 53142 | 2016-01-04 |
| 1225409485 | Antonia Marie Decker | Physician Assistant | 10400 75th St. Ste 204, Kenosha, WI 53142 | 2015-10-14 |
| 1780060582 | Joshua Haas | Pharmacist | 7701 Green Bay Road, Kenosha, IL 53142 | 2015-08-04 |
| 1811379225 | Dana Mary Stout | Registered Nurse | 7401 104th Avenue, Suite 110, Comprehensive Orthopaedics, S.c., Kenosha, WI 53142 | 2015-06-22 |
| 1669815569 | Joshua Knute Elson | Radiology | 6811 118th Ave, Kenosha, WI 53142 | 2013-04-10 |
| 1356610166 | Michael J Gallo | Pharmacist | 7535 North Greenbay Rd, Kenosha, WI 53142 | 2011-12-22 |
| 1720357999 | Orest Carnevale | Registered Nurse | 7316 155th Ct, Kenosha, WI 53142 | 2011-12-18 |
| Find all providers in zip 53142 | ||||
| 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 |
|---|---|---|---|---|
| 1841626785 | B7 Pharmacy Inc | Pharmacy | 3825 39th Ave Ste 100, Kenosha, WI 53144 | 2013-09-24 |
| 1295014959 | Roundys Supermarkets Inc | Pharmacy | 2811 18th St, Kenosha, WI 53140-4665 | 2011-08-12 |
| 1891843157 | Roundys Supermarkets Inc | Pharmacy | 1901 63rd St, Kenosha, WI 53143-4467 | 2007-01-05 |
| 1285704890 | B7 Pharmacy, Inc. | Pharmacy | 3207 80th St, Suite 100, Kenosha, WI 53142-4908 | 2006-11-09 |
| 1356358238 | Walgreen Co | Pharmacy | 3805 80th St, Kenosha, WI 53142-4951 | 2006-08-02 |
| 1760497812 | Walgreen Co | Pharmacy | 3820 52nd St, Kenosha, WI 53144-2624 | 2006-07-29 |
| 1114951332 | Aurora Pharmacy Inc | Pharmacy | 7540 22nd Ave, Kenosha, WI 53143-5702 | 2006-07-11 |
| 1073554945 | Wisconsin Cvs Pharmacy LLC | Pharmacy | 2207 80th St, Kenosha, WI 53143-5756 | 2006-06-09 |
| 1174564041 | Wisconsin Cvs Pharmacy LLC | Pharmacy | 3726 22nd Ave, Kenosha, WI 53140-5300 | 2006-06-09 |
| 1891158440 | Sears Holdings Corporation | Pharmacy | 4100 52nd St, Kenosha, WI 53144-3900 | 2016-03-31 |
| Find all providers in KENOSHA | ||||
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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.