MENOMINEE INDIAN TRIBE OF WISCONSIN (NPI# 1972545010) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972545010 |
| Entity Type | Organization |
| Organization Name | MENOMINEE INDIAN TRIBE OF WISCONSIN |
| Other Organization Name | MENOMINEE TRIBAL CLINIC PHARMACY |
| Practice Address |
W3275 Wolf River Road Keshena WI 54135 |
| Mailing Address |
Po Box 970 Keshena WI 54135-0970 |
| Practice Telephone | 7157993361 |
| Practice Fax Number | 7157993099 |
| Mailing Telephone | 7157993361 |
| Mailing Fax Number | 7157993099 |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2007-10-25 |
| Authorized Official Name | JERRY L WAUKAU SR. (HEALTH ADMINISTRATOR) |
| Authorized Official Telephone | 7157993361 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
7848-042 | WI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 32955700 | 05 | |
| NAPB # | 5118446 | 01 | |
| DEA # | AM7763419 | 01 |
| Other Name | Type Code |
|---|---|
| Menominee Tribal Clinic Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124291802 | Menominee Indian Tribe of Wisconsin | Clinic/Center | W3275 Wolf River Road, Keshena, WI 54135 | 2008-04-02 |
| 1164618088 | Menominee Indian Tribe of Wisconsin | Clinic/Center | W3275 Wolf River Road, Keshena, WI 54135 | 2007-09-25 |
| 1518153436 | Menominee Indian Tribe of Wisconsin | Clinic/Center | W3275 Wolf River Road, Keshena, WI 54135 | 2007-09-25 |
| 1568404721 | Menominee Indian Tribe of Wisconsin | Clinic/Center | W3275 Wolf River Road, Keshena, WI 54135 | 2006-06-12 |
| 1508808643 | Menominee Indian Tribe of Wisconsin | Ambulance | W3275 Wolf River Road, Keshena, WI 54135 | 2006-06-12 |
| Street Address |
W3275 WOLF RIVER ROAD |
| City | KESHENA |
| State | WI |
| Zip Code | 54135 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225033137 | Robert P Chelberg | Optometrist | W3275 Wolf River Road, Keshena, WI 54135 | 2005-06-16 |
| 1104200419 | Leah Rouse | Psychologist | W3275 Wolf River Road, Keshena, WI 54135-0970 | 2015-07-16 |
| 1407236359 | Matthew J Charging | Dentist | W3275 Wolf River Road, Keshena, WI 54135-0970 | 2015-06-05 |
| 1285040428 | Sarah Harkey | Nurse Practitioner | W3275 Wolf River Road, Keshena, WI 54135 | 2014-07-09 |
| 1336581313 | Jodi L Lindroth | Physical Therapist | W3275 Wolf River Road, Menomineetribal Clinic, Keshena, WI 54135-0970 | 2013-07-19 |
| 1962740258 | Jodi L. Opper | Counselor | W3275 Wolf River Road, Menominee Tribal Clinic, Keshena, WI 54135-0970 | 2013-01-22 |
| 1518213115 | Estelle Ostgard | Family Medicine | W3275 Wolf River Road, Menominee Tribal Clinic, Keshena, WI 54135-0970 | 2012-08-01 |
| 1306113873 | Scott Krueger | Dietitian, Registered | W3275 Wolf River Road, Keshena, WI 54135-0970 | 2011-11-28 |
| 1912295080 | Paul M Lorentson | Dentist | W3275 Wolf River Road, Keshena, WI 54135-0970 | 2011-07-11 |
| 1235464801 | Jean Lund | Dental Hygienist | W3275 Wolf River Road, Keshena, WI 54135 | 2009-10-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801278890 | James Garrett Hines | Dentist | W3275 Wolf River Drive, Menominee Tribal Clinic, Keshena, WI 54135 | 2015-06-25 |
| 1447573654 | Menominee County Health & Human Services | Community/Behavioral Health | W3272 Wolf River Rd, Keshena, WI 54135 | 2010-03-03 |
| 1689850349 | Katherine Ellen Marienfeld | Internal Medicine | W 3275 Wolf River Drive, Keshena, WI 54135 | 2008-01-11 |
| 1811196645 | Menominee County Health & Human Services | Public Health or Welfare | W3272 Wolf River Road, Keshena, WI 54135 | 2007-07-12 |
| 1295777415 | Roger W Barr | Social Worker | W3275 Wolf River Dr, Keshena, WI 54135 | 2006-06-12 |
| 1336134824 | Carol J Foss | Psychologist | W3275, Wolf River Road, Keshena, WI 54135 | 2005-09-12 |
| 1174902209 | Heather Marie Nennig | Family Medicine | W3275 Wolf River Dr, Keshena, WI 54135 | 2015-05-21 |
| 1023364668 | Danielle Faye Hoskins | Counselor | W3272 Wolf River Road, Keshena, WI 54135-0280 | 2012-08-01 |
| 1598128340 | Ryan Forbey | Counselor | W3275 Wolf River Dr, Keshena, WI 54135-0970 | 2016-03-30 |
| 1386823763 | Menominee Indian School District | Local Education Agency (LEA) | N522 State Highway 47/55, Keshena, WI 54135-1330 | 2007-11-01 |
| Find all providers in zip 54135 | ||||
| Taxonomy Code | 3336C0002X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Clinic Pharmacy |
| A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. |
| 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 |
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| 1982252813 | Froedtert Health Pharmacy LLC | Pharmacy | 9200 W Wisconsin Ave Ste 100e, Milwaukee, WI 53226-3522 | 2019-09-04 |
| 1487213237 | Aurora Pharmacy Inc | Pharmacy | 9000 W Sura Ln Ste 100, Greenfield, WI 53228-3477 | 2019-06-06 |
| 1295208114 | Aurora Pharmacy Inc | Pharmacy | 1475 W Grand Ave Ste 100, Port Washington, WI 53074-2074 | 2019-01-03 |
| 1144705880 | Aurora Pharmacy Inc. | Pharmacy | 135 Jackson St Ste 100, Oshkosh, WI 54901-4713 | 2018-09-28 |
| 1336634229 | Aurora Pharmacy Inc. | Pharmacy | 3003 University Dr Ste 1, Marinette, WI 54143-4110 | 2018-06-25 |
| 1285128215 | Aurora Pharmacy Inc | Pharmacy | 3509 Dewey Street, Suite 100, Manitowoc, WI 54220 | 2018-06-22 |
| 1629592688 | Aurora Pharmacy Inc | Pharmacy | 200 E Ryan Rd Ste 101, Oak Creek, WI 53154-4563 | 2017-08-01 |
| 1003362179 | Aurora Pharmacy Inc | Pharmacy | 12500 Aurora Dr Ste 1000, Pleasant Prairie, WI 53158-1227 | 2016-08-29 |
| 1578984571 | Aurora Pharmacy Inc. | Pharmacy | 201 E. Morrissey Dr, Suite 100, Elkhorn, WI 53121 | 2013-12-18 |
| 1952630857 | Marshfield Clinic, Inc. | Pharmacy | 1000 N Oak Ave Ste 300, Marshfield, WI 54449 | 2009-12-24 |
| 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.