WISCONSIN CVS PHARMACY LLC (NPI# 1396014908) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396014908 |
| Entity Type | Organization |
| Organization Name | WISCONSIN CVS PHARMACY LLC |
| Other Organization Name | CVS PHARMACY #04996 |
| Practice Address |
N83 W15550 Appleton Avenue Menomonee Falls WI 53051 |
| Mailing Address |
1 Cvs Dr Box 1075 - Pharmacy Enrollments Woonsocket RI 02895-6146 |
| Practice Telephone | 2622535056 |
| Mailing Telephone | 2622535056 |
| Enumeration Date | 2011-12-28 |
| Last Update Date | 2012-09-07 |
| Authorized Official Name | SUSAN F COLBERT (DIRECTOR, PAYER RELATIONS) |
| Authorized Official Telephone | 4017702751 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | PHARMACY STATE LICENSE | 9112-42 | 01 |
| DEA | FW3046732 | 01 | |
| WI | NCPDP | 5132977 | 01 |
| WI | 1396014908 | 05 |
| Other Name | Type Code |
|---|---|
| CVS PHARMACY #04996 | 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 |
| 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 |
| 1306134655 | Wisconsin Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 930 Main Street, Green Bay, WI 54301-4806 | 2011-07-20 |
| Street Address |
N83 W15550 APPLETON AVENUE |
| City | MENOMONEE FALLS |
| State | WI |
| Zip Code | 53051 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356968002 | Marisa Hiley | Nurse Practitioner | W129 N7055 Northfield Drive, Menomonee Falls, WI 53051 | 2020-06-29 |
| 1225687940 | Andres Sercovich | Pharmacist | W12501 Leatherwood Ct N74, Menomonee Falls, WI 53051 | 2019-09-05 |
| 1699329193 | Athletico Ltd | Physical Therapist | N88w15562 Main St, Menomonee Falls, WI 53051 | 2019-08-01 |
| 1386103059 | Aegis Group Practice LLC | Occupational Therapist | N48w14250 W Hampton Ave, Menomonee Falls, WI 53051 | 2019-03-13 |
| 1962969220 | Paladina Health, LLC | Family Medicine | Paladina Health Menomonee Falls, N84 W15787 Menomonee Avenue Suite 6, Menomonee Falls, WI 53051 | 2019-02-22 |
| 1053814772 | Waukesha County Community Dental Clinic, Inc. | Clinic/Center | N81w15062 Appleton Ave, Menomonee Falls, WI 53051 | 2018-03-09 |
| 1942753314 | Kelly Schmidt | Pharmacist | 200 Woodland Prime Ste 300, Menomonee Falls, WI 53051 | 2016-08-02 |
| 1386027548 | Generations Family Dental Care Menomonee Falls, LLC | Dentist | N48 W14170 Hampton Ave., Menomonee Falls, WI 53051 | 2015-07-07 |
| 1184007551 | Monjot Kaur Kang | Pharmacist | N82 W15882 Appleton Ave, Menomonee Falls, WI 53051 | 2015-07-03 |
| 1417334038 | Costco Wholesale Corporation | Hearing Aid Equipment | 9235 Pershing Avenue, Menomonee Falls, WI 53051 | 2015-05-04 |
| Find all providers in zip 53051 | ||||
| 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 |
|---|---|---|---|---|
| 1497063895 | Aurora Pharmacy, Inc. | Pharmacy | N93w14575 Whittaker Way, Menomonee Falls, WI 53051-1652 | 2010-09-20 |
| 1447345640 | Mike Flint Enterprises Inc | Pharmacy | N85w15882 Appleton Ave, Menomonee Falls, WI 53051 | 2006-10-04 |
| 1508890724 | Aurora Pharmacy Inc | Pharmacy | N95w18273 County Line Rd, Menomonee Falls, WI 53051-1333 | 2006-07-11 |
| 1144878075 | Froedtert Health Pharmacy LLC | Pharmacy | W180n8000 Town Hall Rd, Menomonee Falls, WI 53051-4002 | 2019-09-04 |
| 1053969980 | Froedtert Health Pharmacy LLC | Pharmacy | W180n8085 Town Hall Rd, Menomonee Falls, WI 53051-3518 | 2019-09-04 |
| 1073162905 | Froedtert Health Pharmacy LLC | Pharmacy | N86w12999 Nightingale Way, Menomonee Falls, WI 53051-2102 | 2019-09-04 |
| 1366090599 | Community Memorial Hospital of Menomonee Falls, Inc. | Pharmacy | N86w12999 Nightingale Way, Menomonee Falls, WI 53051-2102 | 2019-08-30 |
| 1710535026 | Froedtert Health Pharmacy LLC | Pharmacy | N86w12999 Nightingale Way, Menomonee Falls, WI 53051-2102 | 2019-08-29 |
| 1457604928 | Froedtert Memorial Lutheran Hospital, Inc. | Pharmacy | W180n8000 Town Hall Rd, Menomonee Falls, WI 53051-4002 | 2012-10-22 |
| 1487829727 | Aurora Pharmacy, Inc. | Pharmacy | N84w16889 Menomonee Ave, Suite 1408, Menomonee Falls, WI 53051-2810 | 2008-04-28 |
| Find all providers in MENOMONEE FALLS | ||||
| City | MENOMONEE FALLS |
| Zip Code | 53051 |
Please comment or provide details below to improve the information on WISCONSIN CVS PHARMACY LLC.
| 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.