MORELAND PLAZA PHARMACY, INC (NPI# 1821584343) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821584343 |
| Entity Type | Organization |
| Organization Name | MORELAND PLAZA PHARMACY, INC |
| Practice Address |
827 W Moreland Blvd Waukesha WI 53188-2963 |
| Practice Telephone | 2625424488 |
| Practice Fax Number | 2626504040 |
| Mailing Telephone | 2625424488 |
| Mailing Fax Number | 2626504040 |
| Enumeration Date | 2018-07-09 |
| Last Update Date | 2018-07-09 |
| Authorized Official Name | SCOTT HOFF (OWNER) |
| Authorized Official Telephone | 2625424488 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
4015-42 | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 33195300 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619071628 | Moreland Plaza Pharmacy, Inc | Pharmacy | 827 W Moreland Blvd, Waukesha, WI 53188-2963 | 2006-09-11 |
| 1831202399 | Moreland Plaza Pharmacy, Inc | Pharmacy | 1111 Delafield St, Suite 109, Waukesha, WI 53188-3417 | 2006-08-17 |
| Street Address |
827 W MORELAND BLVD |
| City | WAUKESHA |
| State | WI |
| Zip Code | 53188-2963 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619071628 | Moreland Plaza Pharmacy, Inc | Pharmacy | 827 W Moreland Blvd, Waukesha, WI 53188-2963 | 2006-09-11 |
| 1215378518 | Paul J Anonich | Pharmacist | 827 W Moreland Blvd, Waukesha, WI 53188-2963 | 2013-07-15 |
| 1720325731 | Scott Hoff | Pharmacist | 827 W Moreland Blvd, Waukesha, WI 53188-2963 | 2013-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336787126 | Nicole Lee Berg-johnson | Nurse Practitioner | 820 Crestwood Dr., Waukesha, WI 53188 | 2019-12-12 |
| 1013475706 | Rachel Mueller | Occupational Therapist | 29667 Summit Ave, S11, Waukesha, WI 53188 | 2019-03-12 |
| 1861962649 | Emily Elizabeth Seefeld | Occupational Therapy Assistant | 29667 Summit Ave S11, Waukesha, WI 53188 | 2018-12-05 |
| 1003393307 | Ashley Susan Callahan | Dental Hygienist | 711 W. Moreland Blvd., Suite 204, Waukesha, WI 53188 | 2018-07-19 |
| 1245741321 | Melissa Weir | Case Manager/Care Coordinator | 514 Riverview Avenue, Waukesha, WI 53188 | 2017-10-17 |
| 1093233629 | Patricia Marie Sombrio | Dental Hygienist | 711 Moreland Blvd 204, Waukesha, WI 53188 | 2017-09-04 |
| 1134660244 | Bdg of Wisconsin, Inc. | Behavioral Analyst | N19w2309 Riverwood Drive, Suite 350 Pmb 314, Waukesha, WI 53188 | 2017-03-09 |
| 1255888731 | Lynne Sarah Alva | Dental Hygienist | 711 Moreland Blvd, Suite 204, Waukesha, WI 53188 | 2016-09-01 |
| 1881069730 | Michelle Koch | Occupational Therapist | 29667 Summit Ave. S11, Waukesha, WI 53188 | 2015-12-03 |
| 1952711012 | Rhonda Schroeder | Dental Hygienist | W286 N991 Shepherds Way, Waukesha, WI 53188 | 2014-04-29 |
| Find all providers in zip 53188 | ||||
| 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] |
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| 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 |
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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.