GUNDERSEN CLINIC LTD (NPI# 1548710627) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548710627 |
| Entity Type | Organization |
| Organization Name | GUNDERSEN CLINIC LTD |
| Other Organization Name | GUNDERSEN PHARMACY - CASS STREET |
| Practice Address |
528 Cass St La Crosse WI 54601-4507 |
| Practice Telephone | 6087849922 |
| Practice Fax Number | 6087842212 |
| Mailing Telephone | 6087849922 |
| Mailing Fax Number | 6087842212 |
| Enumeration Date | 2016-10-12 |
| Last Update Date | 2020-11-08 |
| Authorized Official Name | LOREN CARRELL (ADMINISTRATIVE DIRECTOR) |
| Authorized Official Telephone | 6087756369 |
| Is Organization Subpart | Y |
| Parent Organization Name | GUNDERSEN CLINIC LTD |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
9419-42 | WI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 100063781 | 05 | |
| MN | 1548710627 | 05 | |
| PK | 2163891 | 01 |
| Other Name | Type Code |
|---|---|
| Cass St Pharmacy Gundersen Health System | Doing Business As Name - Organization |
| Cass St Pharmacy Gundersen Health System | Other Name - Individual/Organization |
| Gundersen Pharmacy - Cass Street | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952915639 | Gundersen Clinic Ltd | Clinic/Center | 2615 George St, La Crosse, WI 54603-1670 | 2020-09-01 |
| 1225503428 | Gundersen Clinic Ltd | Pharmacy | 123 Hale Dr Ste 1, Holmen, WI 54636-8933 | 2018-10-04 |
| 1396234837 | Gundersen Clinic Ltd | Optometrist | 402a W Lake St, Friendship, WI 53934 | 2018-05-09 |
| 1396099065 | Gundersen Clinic Ltd | Clinic/Center | 108 S 3rd St, Arcadia, WI 54612 | 2012-11-02 |
| 1235773136 | Gundersen Clinic Ltd | Pharmacy | 1122 W Highway 61 Ste A, Winona, MN 55987-1957 | 2019-11-04 |
| 1164080099 | Gundersen Clinic Ltd | Clinic/Center | 201 3rd St N, La Crosse, WI 54601-3208 | 2019-06-05 |
| 1952967358 | Gundersen Clinic Ltd | Pharmacy | 505 Gopher Dr Ste A, Tomah, WI 54660-4513 | 2019-05-13 |
| 1245705441 | Gundersen Clinic Ltd | Pharmacy | 2511 Green Bay St, La Crosse, WI 54601-5900 | 2018-10-04 |
| 1497220693 | Gundersen Clinic Ltd | Pharmacy | 111 Sand Lake Rd, Onalaska, WI 54650-2760 | 2018-10-04 |
| 1306347141 | Gundersen Clinic Ltd | Clinic/Center | 516 Montgomery St, Decorah, IA 52101-2720 | 2018-02-27 |
| Street Address |
528 CASS ST |
| City | LA CROSSE |
| State | WI |
| Zip Code | 54601-4507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578587606 | Kcje Ford Inc | Durable Medical Equipment & Medical Supplies | 528 Cass St, La Crosse, WI 54601-4507 | 2006-07-26 |
| 1841740891 | Kassandra Weber | Pharmacist | 528 Cass St, La Crosse, WI 54601-4507 | 2016-10-13 |
| 1023441805 | Rachel J Arfstrom | Pharmacist | 528 Cass St, La Crosse, WI 54601-4507 | 2013-08-15 |
| 1760736037 | Lacey Marie David | Pharmacist | 528 Cass St, La Crosse, WI 54601-4507 | 2012-11-07 |
| 1740535822 | Rebecca Ruth Hansen | Pharmacist | 528 Cass St, La Crosse, WI 54601-4507 | 2012-07-16 |
| 1801052295 | Jessie Bawek | Pharmacist | 528 Cass St, La Crosse, WI 54601-4507 | 2008-08-05 |
| 1275710618 | Stephanie Ann Belling | Pharmacist | 528 Cass St, La Crosse, WI 54601-4507 | 2008-01-29 |
| 1609880848 | Kenneth Wayne Ford | Pharmacist | 528 Cass St, La Crosse, WI 54601-4507 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891324265 | Meagan Mcrae | Student in an Organized Health Care Education/Training Program | 1725 State St., 4051 Health Science Center, La Crosse, WI 54601 | 2020-04-07 |
| 1255969671 | Erin Dingman | Student in an Organized Health Care Education/Training Program | 1751 State Street, 4051 Health Science Center, La Crosse, WI 54601 | 2020-03-31 |
| 1619505047 | Nicole Kay Lynch | Student in an Organized Health Care Education/Training Program | 4051 Health Science Center, 1725 State St, La Crosse, WI 54601 | 2020-03-31 |
| 1174151757 | Jenna Sells | Student in an Organized Health Care Education/Training Program | 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 | 2020-03-30 |
| 1740818301 | Katie Irene Tahtinen | Student in an Organized Health Care Education/Training Program | Uwl- 4051 Health Science Center, 1725 State St., La Crosse, WI 54601 | 2020-03-30 |
| 1932737517 | Margaret May Grimm | Student in an Organized Health Care Education/Training Program | Univesity of Wisconsin-la Crosse, 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 | 2020-03-30 |
| 1831727312 | Matthew Timothy Axler | Student in an Organized Health Care Education/Training Program | 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 | 2020-03-30 |
| 1093340473 | Denise Stinson | Technician | 1311 Badger St, Apt 505, La Crosse, WI 54601 | 2020-03-06 |
| 1922632397 | Ibrahim Ahsan | Pharmacist | 1105 Wi-16, La Crosse, WI 54601 | 2020-02-25 |
| 1750913356 | Liza R Collins | Massage Therapist | 1415 State Wi 16, La Crosse, WI 54601 | 2020-02-11 |
| Find all providers in zip 54601 | ||||
| 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 |
|---|---|---|---|---|
| 1629490255 | Genoa Healthcare, LLC | Pharmacy | 1707 Main St Ste 102, La Crosse, WI 54601-4200 | 2014-01-16 |
| 1245276260 | Barrows Healthmart Pharmacy | Pharmacy | 721 Main, La Crosse, KS 67548 | 2006-06-20 |
| 1497299762 | Pharmacy Compounding Center Associates LLC | Pharmacy | 1907 West Ave S, La Crosse, WI 54601-6206 | 2016-12-06 |
| 1679920698 | Rush County Pharmacy LLC | Pharmacy | 708 Main St, La Crosse, KS 67548 | 2016-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942816939 | The Duluth Clinic, Ltd. | Pharmacy | 204 Belknap St, Ste 100, Superior, WI 54880-2964 | 2020-09-16 |
| 1902417207 | Ipack Pharmacy LLC | Pharmacy | 17000 W North Ave Ste 108w, Brookfield, WI 53005-4423 | 2020-08-11 |
| 1851939037 | Ascension Wisconsin Pharmacy, Inc | Pharmacy | 10180 Washington Ave Ste 102, Mount Pleasant, WI 53177-1604 | 2019-12-18 |
| 1558906354 | Life Change Rx 4 LLC | Pharmacy | 6300 N 76th St Ste 246, Milwaukee, WI 53218-1208 | 2019-11-15 |
| 1285278978 | Life Change Rx 3 LLC | Pharmacy | 7115 W Capitol Dr, Milwaukee, WI 53216-2051 | 2019-11-05 |
| 1295377703 | Hayat Pharmacy 21 LLC. | Pharmacy | 2333 Northwestern Ave Ste 120, Racine, WI 53404-2520 | 2019-10-16 |
| 1487296737 | Xperience Pharmacy LLC | Pharmacy | 5715 W Appleton Ave, Milwaukee, WI 53210-2250 | 2019-10-08 |
| 1962053421 | Hayat Pharmacy 19 LLC | Pharmacy | 805 W. Layton Ave. Suite A, Milwaukee, WI 53221 | 2019-09-26 |
| 1275182925 | Walgreen Co | Pharmacy | 2265 N Mayfair Rd, Wauwatosa, WI 53226-2207 | 2019-09-05 |
| 1982257200 | Hayat Pharmacy 16 LLC | Pharmacy | 603 N 36th St, Milwaukee, WI 53208-3826 | 2019-07-17 |
| Find all providers with the same taxonomy | ||||
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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.