FHHP- KEWASKUM LLC (NPI# 1790121382) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790121382 |
| Entity Type | Organization |
| Organization Name | FHHP- KEWASKUM LLC |
| Other Organization Name | FHHP KEWASKUM |
| Practice Address |
901 Fond Du Lac Ave Kewaskum WI 53040-9161 |
| Mailing Address |
333 Lowville Rd Rio WI 53960-9437 |
| Practice Telephone | 2624771700 |
| Practice Fax Number | 2624771703 |
| Mailing Telephone | 9209926800 |
| Mailing Fax Number | 9209926801 |
| Enumeration Date | 2013-05-22 |
| Last Update Date | 2018-07-19 |
| Authorized Official Name | DIANE DEANS (CONGTRACTING SPECIALIST) |
| Authorized Official Telephone | 9209926800 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
9203-42 | WI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 100031537 | 05 | |
| PK | 2140522 | 01 |
| Other Name | Type Code |
|---|---|
| FHHP Kewaskum | Doing Business As Name - Organization |
| Street Address |
901 FOND DU LAC AVE |
| City | KEWASKUM |
| State | WI |
| Zip Code | 53040-9161 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437761277 | Kathryn Anne Bublitz | Pharmacist | 901 Fond Du Lac Ave, Kewaskum, WI 53040-9161 | 2020-08-22 |
| 1912566027 | Erin Orth | Pharmacist | 901 Fond Du Lac Ave, Kewaskum, WI 53040-9161 | 2019-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902076698 | Craig Alan Bruesewitz | Counselor | 1421 Fond Du Lac Avenue, Kewashum, WI 53040 | 2008-03-10 |
| 1508040700 | Sara Marie Bonlender | Licensed Practical Nurse | 1841 Edgewood Road, Kewaskum, WI 53040 | 2007-12-24 |
| 1861506255 | Kewaskum Fire Department | Ambulance | 1106 Fond Du Lac Ave, Kewaskum, WI 53040 | 2006-08-19 |
| 1619219532 | Cheryl Elizabeth Colwin | Counselor | 1421 Fond Du Lac Avenue, Kewaskum, WI 53040 | 2013-03-18 |
| 1790188498 | Nicolai Gerhartz | Physician Assistant | W832 County Rd S, Kewaskum, WI 53040-1116 | 2014-10-08 |
| 1871785931 | Kewaskum School District | Speech-Language Pathologist | 1676 Reigle Dr Ste 100, Kewaskum, WI 53040-8923 | 2007-08-13 |
| 1891801957 | J Dennis Connor | Dentist | 1204 Fond Du Lac Ave, Kewaskum, WI 53040-8954 | 2006-08-22 |
| 1003941444 | J Dennis Connor Dds Sc | Dentist | 1204 Fond Du Lac Ave, Kewaskum, WI 53040-8954 | 2007-02-23 |
| 1093241002 | Nicholas Brandon Bier | Student in an Organized Health Care Education/Training Program | 311 Clinton St, Kewaskum, WI 53040-9116 | 2017-05-11 |
| 1518976919 | West Bend Clinic | Internal Medicine | 1701 Fond Du Lac Ave, Kewaskum, WI 53040-9129 | 2006-08-05 |
| Find all providers in zip 53040 | ||||
| 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 |
|---|---|---|---|---|
| 1154355378 | Aurora Pharmacy Inc | Pharmacy | 927 Fond Du Lac Ave, Kewaskum, WI 53040-9161 | 2006-07-11 |
| 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 | ||||
Please comment or provide details below to improve the information on FHHP- KEWASKUM LLC.
| 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.