AMANDA MARIE GOODALL (NPI# 1578162954) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578162954 |
| Entity Type | Individual |
| Full Name | AMANDA MARIE GOODALL |
| Credential | PHARMD |
| Practice Address |
2950 New Pinery Rd Portage WI 53901-9225 |
| Mailing Address |
3072 Larsen Rd Madison WI 53711-5729 |
| Practice Telephone | 6087421670 |
| Practice Fax Number | 6087421769 |
| Mailing Telephone | 6083331559 |
| Enumeration Date | 2020-10-18 |
| Last Update Date | 2020-10-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
18793-40 | WI | Suppliers |
| Street Address |
2950 NEW PINERY RD |
| City | PORTAGE |
| State | WI |
| Zip Code | 53901-9225 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265459317 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 2950 New Pinery Rd, Portage, WI 53901-9225 | 2006-07-16 |
| 1326647272 | Ciaran Patrick Kelly | Pharmacist | 2950 New Pinery Rd, Portage, WI 53901-9225 | 2020-10-21 |
| 1568061745 | Daniel John Sobczak | Pharmacist | 2950 New Pinery Rd, Portage, WI 53901-9225 | 2020-10-20 |
| 1043391964 | Wal-mart Stores East, Lp | Technician/Technologist | 2950 New Pinery Rd, Portage, WI 53901-9225 | 2006-10-18 |
| 1891802427 | Ronald J. Bound Jr. | Optometrist | 2950 New Pinery Rd, Portage, WI 53901-9225 | 2006-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740710748 | Robert James Corliss | Internal Medicine | St. Vincent Fmc, 140east Cook St., Portage, WI 53901 | 2017-06-13 |
| 1639328867 | Casey Jo Ambort | Speech-Language Pathologist | 626 East Slifer St, Portage, WI 53901 | 2008-09-11 |
| 1871767400 | Planned Parenthood of Wi, Inc | Non-Pharmacy Dispensing Site | 132 W. Cook St., Portage, WI 53901 | 2008-04-15 |
| 1881872158 | Marta Jean Jindra | Physical Therapist | 626 E Slifer Street, Portage, WI 53901 | 2008-02-08 |
| 1699953976 | Lana Marie Edwards | Speech-Language Pathologist | 626 East Slifer Street, Portage, WI 53901 | 2008-02-08 |
| 1134314552 | Kristina Hellenbrand | Physical Therapist | 2639 New Pinery Road, Suite 2, Portage, WI 53901 | 2007-09-10 |
| 1689727810 | Gregory Allan Bindl | Chiropractor | 2121new Pinery Rd, Portage, WI 53901 | 2007-01-19 |
| 1720149156 | Timothy J Rosin Dds Sc | Dentist | 2570 New Pinery Rd, Portage, WI 53901 | 2006-12-12 |
| 1710083779 | Currani Seubert Dental Office LLC | Dentist | 260 W Cook St, Portage, WI 53901 | 2006-09-16 |
| 1225090525 | University of Wisconsin Medical Foundation Inc | Durable Medical Equipment & Medical Supplies | 2977 Cty Hwy Cx, Portage, WI 53901 | 2006-04-04 |
| Find all providers in zip 53901 | ||||
| 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 |
|---|---|---|---|---|
| 1972082881 | Dean Retail Services, Inc. | Pharmacy | 2825 Hunters Trl Ste 300, Portage, WI 53901-3429 | 2018-08-10 |
| 1386957207 | Tandon's Advanced Pharmacy Inc. | Pharmacy | 7916 Oakland Dr, Portage, MI 49024-4936 | 2010-07-20 |
| 1437252129 | Hook Superx LLC | Pharmacy | 3240 Willowcreek Rd, Portage, IN 46368-5055 | 2006-09-07 |
| 1922015916 | Walgreen Co | Pharmacy | 5995 Us Highway 6, Portage, IN 46368-4945 | 2006-08-02 |
| 1992735666 | Portage Pharmacy, Inc. | Pharmacy | 7966 Lovers Ln, Portage, MI 49002-4446 | 2006-07-05 |
| 1154389302 | Pharma-card, Inc | Pharmacy | 6036 Lute Rd, Suite A, Portage, IN 46368-5008 | 2006-05-03 |
| 1588048672 | Walgreens | Pharmacy | 5933 S Westnedge Ave, Portage, MI 49002-1455 | 2015-07-17 |
| 1174677611 | Borgess Medical Center | Pharmacy | 7901 Angling Rd, Portage, MI 49024-0714 | 2007-01-22 |
| 1750440756 | Family Fare, LLC | Pharmacy | 525 Romence Rd, Portage, MI 49024-3444 | 2006-12-06 |
| 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.