WISCONSIN CVS PHARMACY, L.L.C. (NPI# 1780090415) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780090415 |
| Entity Type | Organization |
| Organization Name | WISCONSIN CVS PHARMACY, L.L.C. |
| Other Organization Name | CVS PHARMACY #10411 |
| Practice Address |
433 Broadway St S Menomonie WI 54751-1822 |
| Mailing Address |
1 Cvs Dr Boc 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 7152355349 |
| Practice Fax Number | 7152355379 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2014-11-19 |
| Authorized Official Name | SUSAN COLBERT (DIRECTOR, PAYER RELATIONS) |
| Authorized Official Telephone | 4017651500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | WI | Suppliers | |
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
WI | Suppliers | |
| Y | 333600000X | Pharmacy | WI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1780090415 | 05 | |
| WI | NCPDP | 5134414 | 01 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #10411 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942686068 | Wisconsin Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 535 E. Division Ave., Barron, WI 54812 | 2015-07-31 |
| 1245615640 | Wisconsin Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 3915 Durand Ave, Elmwood Park, WI 53405-4402 | 2015-07-27 |
| 1265813364 | Wisconsin Cvs Pharmacy, L.L.C. | Pharmacy | 1108 N 14th St, Sheboygan, WI 53081-3213 | 2015-06-15 |
| 1114310885 | Wisconsin Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 2200 Bracket Ave., Eau Claire, WI 54701-4619 | 2015-03-05 |
| 1043625924 | Wisconsin Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 1407 Egg Harbor Rd, Sturgeon Bay, WI 54235-1239 | 2014-06-30 |
| 1467772673 | Wisconsin Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 2 S Bedford St, Madison, WI 53703-2624 | 2010-06-10 |
| 1336463124 | Wisconsin Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 17165 W Bluemound Rd, Brookfield, WI 53005-5917 | 2010-03-23 |
| 1013144971 | Wisconsin Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 5220 West Rawson Ave, Franklin, WI 53132 | 2009-06-18 |
| Street Address |
433 BROADWAY ST S |
| City | MENOMONIE |
| State | WI |
| Zip Code | 54751-1822 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598390882 | Seok Yeong Kim | Pharmacist | 433 Broadway St S, Menomonie, WI 54751-1822 | 2020-03-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154840569 | Ashley Friedenfels | Physical Medicine & Rehabilitation | E4486 290th Avenue, Menomonie, WI 54751 | 2017-09-18 |
| 1215307814 | David Calvin Reimann | Hearing Instrument Specialist | E4584 483rd Avenue, Menomonie, WI 54751 | 2015-09-25 |
| 1790128627 | County of Dunn | Skilled Nursing Facility | 651 Howison Circle, Menominie, WI 54751 | 2013-04-10 |
| 1043653983 | County of Dunn | Skilled Nursing Facility | 658 Howison Circle, Menomonie, WI 54751 | 2013-04-10 |
| 1447519236 | Gentle Dental Care LLC | Dentist | 1813 Wilson St., Menomonie, WI 54751 | 2012-05-14 |
| 1386960193 | Kilimanjaro LLC | Non-emergency Medical Transport (VAN) | 1222 14th Ave E, Menomonie, WI 54751 | 2010-04-19 |
| 1275709180 | Dianne Marie Bennett | Counselor | 1916 2nd St W, Menomonie, WI 54751 | 2008-05-01 |
| 1417136201 | David Gary Hackbarth | Chiropractor | 3120 Schneider Ave E, Suite #5, Menomonie, WI 54751 | 2007-10-29 |
| 1306057336 | Tonia D. Behling | Dental Hygienist | 3375 Kothlow Ave., Suite 40, Menomonie, WI 54751 | 2007-05-24 |
| 1295956282 | Danny Roger Wood | Dentist | 1603 Stout Rd, Menomonie, WI 54751 | 2007-05-01 |
| Find all providers in zip 54751 | ||||
| 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 |
|---|---|---|---|---|
| 1639574932 | Cpi Menomonie LLC | Pharmacy | 1302 Stout Rd, Menomonie, WI 54751-2979 | 2014-10-29 |
| 1740369057 | Mayo Clinic Health System-northwest Wisconsin Region, Inc. | Pharmacy | 2321 Stout Rd, Menomonie, WI 54751-7003 | 2006-11-06 |
| 1891726949 | K Mart Corp | Pharmacy | 103 Oak Ave, Menomonie, WI 54751-1363 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497355002 | Long Life Pharmacy 2 LLC | Pharmacy | 1225 W Historic Mitchell St Ste 217, Milwaukee, WI 53204-3382 | 2020-11-01 |
| 1710527783 | Sage Specialty Pharmacy Inc. | Pharmacy | 4001 N. Oakland Ave, Shorewood, WI 53211 | 2020-01-08 |
| 1790333623 | Froedtert Health Pharmacy LLC | Pharmacy | 9200 W Wisconsin Ave Ste 200w, Milwaukee, WI 53226-3522 | 2019-09-04 |
| 1225686405 | Froedtert Health Pharmacy LLC | Pharmacy | 9200 W Wisconsin Ave Ste 200c, Milwaukee, WI 53226-3522 | 2019-08-30 |
| 1134777337 | Froedtert Health Pharmacy LLC | Pharmacy | 11430 N Port Washington Rd Ste 103, Mequon, WI 53092-3414 | 2019-08-30 |
| 1619524766 | University Rx LLC | Pharmacy | 133 E College Ave, Appleton, WI 54911 | 2019-08-23 |
| 1053967026 | Accurabenefits, LLC | Pharmacy | 2413 Woodland Ter, Neenah, WI 54956-4824 | 2019-08-14 |
| 1184276917 | St. Clare Health Mission Pharmacy | Pharmacy | 916 Ferry St, La Crosse, WI 54601-4717 | 2019-07-11 |
| 1851851141 | Dean Retail Services, Inc. | Pharmacy | 740 Reena Ave Ste 300, Fort Atkinson, WI 53538-3145 | 2019-03-22 |
| 1093287237 | Del Mar Pharmacy Sc | Pharmacy | 1000 S Cesar E Chavez Dr, Milwaukee, WI 53204-2203 | 2018-12-28 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on WISCONSIN CVS PHARMACY, L.L.C..
| 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.