NICHOLAS L SMITH PHARMACY LLC (NPI# 1780225003) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780225003 |
| Entity Type | Organization |
| Organization Name | NICHOLAS L SMITH PHARMACY LLC |
| Other Organization Name | SMITH PHARMACY - LTC |
| Practice Address |
1800 Freedom Rd Ste D Little Chute WI 54140-3200 |
| Practice Telephone | 9207888888 |
| Practice Fax Number | 9207888883 |
| Mailing Telephone | 9207888888 |
| Mailing Fax Number | 9207888883 |
| Enumeration Date | 2019-10-08 |
| Last Update Date | 2019-11-27 |
| Authorized Official Name | NICHOLAS L SMITH (OWNER/ PHARM D) |
| Authorized Official Telephone | 9207888888 |
| Is Organization Subpart | Y |
| Parent Organization Name | NICHOLAS L SMITH PHARMACY LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers |
| Other Name | Type Code |
|---|---|
| Smith Pharmacy | Doing Business As Name - Organization |
| Smith Pharmacy - LTC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851724637 | Nicholas L Smith Pharmacy LLC | Pharmacy | 1800 Freedom Rd Ste D, Little Chute, WI 54140-3200 | 2013-08-15 |
| Street Address |
1800 FREEDOM RD STE D |
| City | LITTLE CHUTE |
| State | WI |
| Zip Code | 54140-3200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467705947 | Nicholas L Smith | Pharmacist | 1800 Freedom Rd Ste D, Little Chute, WI 54140-3200 | 2012-10-20 |
| 1851724637 | Nicholas L Smith Pharmacy LLC | Pharmacy | 1800 Freedom Rd Ste D, Little Chute, WI 54140-3200 | 2013-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841335536 | Dann Norbert Pynenberg | Dentist | 607 Wilson Street, Little Chute, WI 54140 | 2007-02-20 |
| 1043207707 | Peter J Kordiyak | Physician Assistant | 200 Patriot Drive, Little Chute, WI 54140 | 2005-09-28 |
| 1144731498 | Paul R Garcia | Family Medicine | 200 Patriot Dr, Little Chute, WI 54140 | 2017-10-13 |
| 1538451307 | Jessica L Peterson | Family Medicine | 200 Patriot Drive, Little Chute, WI 54140 | 2011-05-11 |
| 1043478324 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | 200 Patriot Dr, Little Chute, WI 54140 | 2008-05-23 |
| 1164550208 | Ebben & Pynenberg Dds Sc | Dentist | 607 Wilson St, Little Chute, WI 54140 | 2007-03-01 |
| 1134264922 | Michael Charles Ebben | Dentist | 607 Wilson St, Little Chute, WI 54140 | 2007-02-20 |
| 1245335165 | Ascension Medical Group-fox Valley Wisconsin, Inc | Durable Medical Equipment & Medical Supplies | 200 Patriot Dr, Little Chute, WI 54140 | 2006-09-14 |
| 1366809758 | Katie Woldt | Registered Nurse | 1502 Biscayne Dr, Little Chute, WI 54140-1006 | 2016-01-15 |
| 1770878233 | Isabelle Holdridge | Registered Nurse | 1030f W Elm Dr Apt 16, Little Chute, WI 54140-1099 | 2011-06-13 |
| Find all providers in zip 54140 | ||||
| Taxonomy Code | 3336L0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Long Term Care Pharmacy |
| A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
| 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 |
|---|---|---|---|---|
| 1851724637 | Nicholas L Smith Pharmacy LLC | Pharmacy | 1800 Freedom Rd Ste D, Little Chute, WI 54140-3200 | 2013-08-15 |
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|---|---|---|---|---|
| 1922646579 | Medical Health Pharmacy LLC | Pharmacy | 8845 S Greenview Dr Ste 1, Middleton, WI 53562-2562 | 2019-12-13 |
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| 1487205944 | Hayat Pharmacy 20 LLC | Pharmacy | 805 W. Layton Ave., Suite B, Milwaukee, WI 53221 | 2019-09-26 |
| 1568015022 | T A Solberg Co Inc | Pharmacy | 232 S Courtney St Stop 3, Rhinelander, WI 54501-3308 | 2019-07-23 |
| 1932679081 | Janesville Hometown Pharmacy LLC | Pharmacy | 21 S Jackson St Ste 100, Janesville, WI 53548-3859 | 2018-12-03 |
| 1902371107 | Salvanz Enterprises Inc | Pharmacy | 2673 Lineville Rd, Green Bay, WI 54313-7124 | 2018-10-04 |
| 1962999805 | Guardian Pharmacy of Madison, LLC | Pharmacy | N85 W15882 Appleton Ave, Menomonee Falls, WI 53051-3082 | 2018-04-17 |
| 1164932091 | Mabie Pharmacy, LLC | Pharmacy | 10 Liberty St # 106, Deerfield, WI 53531-9458 | 2017-10-05 |
| 1487101754 | Evergreen Pharmacy LLC | Pharmacy | 10101 W Greenfield Ave, West Allis, WI 53214-3953 | 2016-09-05 |
| 1639548142 | Lynja Inc | Pharmacy | 3215 8th St S Ste 101, Wisconsin Rapids, WI 54494-6564 | 2015-09-15 |
| Find all providers with the same taxonomy | ||||
| City | LITTLE CHUTE |
| Zip Code | 54140 |
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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.