WISCONSIN CVS PHARMACY LLC (NPI# 1447291315) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447291315 |
| Entity Type | Organization |
| Organization Name | WISCONSIN CVS PHARMACY LLC |
| Other Organization Name | CVS PHARMACY # 08541 |
| Practice Address |
1561 W Mason St Green Bay WI 54303-2215 |
| Mailing Address |
1 Cvs Dr Po Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 9204975959 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2014-03-07 |
| 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 | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 5128992 | 01 |
| Other Name | Type Code |
|---|---|
| CVS PHARMACY # 08541 | 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 |
1561 W MASON ST |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54303-2215 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497379911 | Sarah Kitchen | Pharmacist | 1561 W Mason St, Green Bay, WI 54303-2215 | 2020-06-01 |
| 1225658636 | Stacey Lynn Mcdonald | Pharmacist | 1561 W Mason St, Green Bay, WI 54303-2215 | 2020-04-26 |
| 1295273894 | Daryl A Fahrner | Pharmacist | 1561 W Mason St, Green Bay, WI 54303-2215 | 2017-02-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952921033 | Ashley Marie Vandermoss | Social Worker | 1601 W Mason Street, Green Bay, WI 54303 | 2020-04-20 |
| 1598307423 | Jean Marie Castaneda | Case Manager/Care Coordinator | 2517 N. Court, Green Bay, WI 54303 | 2019-10-11 |
| 1215579552 | Integrated Treatment Centers, LLC | Clinic/Center | 2311 W Mason Street, Green Bay, WI 54303 | 2019-10-08 |
| 1003460551 | Affordable Dentures & Implants - Green Bay, S.c. | Dentist | 1800-c W. Mason Street, Green Bay, WI 54303 | 2019-08-01 |
| 1164940375 | Kaeley Rae Blaney | Student in an Organized Health Care Education/Training Program | 2088 Memorial Drive #208, Green Bay, WI 54303 | 2017-09-07 |
| 1518498047 | Treatment Providers LLC | Clinic/Center | 2731 N Packerland Dr Ste A, Green Bay, WI 54303 | 2017-03-26 |
| 1851840565 | Back To Balance Chiropractic, LLC | Chiropractor | 110 Packerland Drive, Suite B, Green Bay, WI 54303 | 2016-09-23 |
| 1710361001 | Matthew Lemay | Acupuncturist | 727 E Walnut, Suite B2, Green Bay, WI 54303 | 2015-07-16 |
| 1144600149 | Carrie Jean Banaszak | Counselor | 1039 Mason Street, Green Bay, WI 54303 | 2015-06-04 |
| 1174921993 | Kensey Meyer | Occupational Therapy Assistant | 1555 Dousman Road, Seymour, WI 54303 | 2014-12-10 |
| Find all providers in zip 54303 | ||||
| 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 |
|---|---|---|---|---|
| 1104088020 | Custom Health Pharmacy Inc | Pharmacy | 844 Willard Dr Ste 7, Green Bay, WI 54304-5265 | 2008-07-01 |
| 1033392436 | Shopko Stores Operating Co LLC | Pharmacy | 2320 Lineville Rd, Green Bay, WI 54313-8836 | 2007-12-10 |
| 1386800597 | Bel-regional Home Medical Inc | Pharmacy | 1630 Commanche Ave, Green Bay, WI 54313-5753 | 2008-08-07 |
| 1417988551 | K Mart Corp | Pharmacy | 2201 Main St, Green Bay, WI 54302-3713 | 2006-07-06 |
| 1699706739 | K Mart Corp | Pharmacy | 1109 Lombardi Ave, Green Bay, WI 54304 | 2006-07-06 |
| 1003862442 | Shopko Stores Operating Co LLC | Pharmacy | 2430 E Mason St, Green Bay, WI 54302-3759 | 2006-05-26 |
| 1831144070 | Shopko Stores Operating Co LLC | Pharmacy | 2585 Lineville Rd, Green Bay, WI 54313-7122 | 2006-05-24 |
| 1073568242 | Shopko Stores Operating Co LLC | Pharmacy | 301 Bay Park Sq, Green Bay, WI 54304-5104 | 2006-05-24 |
| 1982659140 | Shopko Stores Operating Co LLC | Pharmacy | 216 S Military Ave, Green Bay, WI 54303-2498 | 2006-05-24 |
| 1104827146 | Streu's Pharmacy, Inc | Pharmacy | 635 Main St, Green Bay, WI 54301-4918 | 2005-08-01 |
| Find all providers in GREEN BAY | ||||
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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.