VERSITI WISCONSIN, INC. (NPI# 1124098330) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124098330 |
| Entity Type | Organization |
| Organization Name | VERSITI WISCONSIN, INC. |
| Other Organization Name | BLOODCENTER OF WISCONSIN, INC. |
| Practice Address |
638 N 18th St Milwaukee WI 53233-2121 |
| Mailing Address |
Po Box 2178 Milwaukee WI 53201-2178 |
| Practice Telephone | 4149376160 |
| Practice Fax Number | 4149337350 |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2018-09-27 |
| Authorized Official Name | RALPH WOODS (MGR THERAPUTIC PROD) |
| Authorized Official Telephone | 4149376123 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
8375-42 | WI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 32950300 | 05 | |
| PK | 2110850 | 01 |
| Other Name | Type Code |
|---|---|
| BLOODCENTER OF WI INC | Doing Business As Name - Organization |
| Bloodcenter of Wisconsin, Inc. | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881784056 | Versiti Wisconsin, Inc. | Pathology | 638 N 18th St, Milwaukee, WI 53233-2121 | 2006-10-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | VERSITI WISCONSIN, INC. | 638 N 18th St, Milwaukee, WI 53233-2121 |
| Street Address |
638 N 18TH ST |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53233-2121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689677148 | Mehraboon S Irani | Pathology | 638 N 18th St, Blood Center of Wisconsin, Milwaukee, WI 53201-2178 | 2005-05-27 |
| 1962038463 | Jennifer Massaro | Nurse Practitioner | 638 N 18th St, Milwaukee, WI 53233-2121 | 2020-03-16 |
| 1013302926 | Waseem Anani | Pathology | 638 N 18th St, Milwaukee, WI 53233-2121 | 2015-03-30 |
| 1942474515 | Barbara Jean Bryant | Pathology | 638 N 18th St, Milwaukee, WI 53233-2121 | 2008-04-15 |
| 1700089406 | Matthew Scott Karafin | Pathology | 638 N 18th St, Milwaukee, WI 53233-2121 | 2007-06-08 |
| 1881784056 | Versiti Wisconsin, Inc. | Pathology | 638 N 18th St, Milwaukee, WI 53233-2121 | 2006-10-16 |
| 1942303250 | Kathleen E Puca | Pathology | 638 N 18th St, Milwaukee, WI 53233-2121 | 2006-09-06 |
| 1376646695 | Rowena C Punzalan | Pathology | 638 N 18th St, Milwaukee, WI 53233-2121 | 2006-09-06 |
| 1487670972 | Stefanie B. N. Dugan | Genetic Counselor, MS | 638 N 18th St, Milwaukee, WI 53233-2121 | 2006-07-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104454750 | Henok Desta Hardilo | Student in an Organized Health Care Education/Training Program | Aurora Sinai Medical Center 945 N 12th Street, Milwaukee, WI 53233 | 2020-03-30 |
| 1821633314 | Ann E Millard | Occupational Therapist | 560 N. 16th Street, Room 214a, Milwaukee, WI 53233 | 2019-11-08 |
| 1306480918 | Teng Kai Ong | Dentist | 1801 West Wisconsin Ave., Milwaukee, WI 53233 | 2019-11-06 |
| 1356800478 | Nebiyu Abera Tilahun | Student in an Organized Health Care Education/Training Program | Aurora Sinai Medical Center, 945 N. 12th Street, Milwaukee, WI 53233 | 2019-03-18 |
| 1548748387 | Emily Claire Goetz | Physical Therapist | 945 N. 12th St. Suite 1100, Milwaukee, WI 53233 | 2018-08-03 |
| 1801373378 | Froedtert & The Medical College of Wisconsin Community Physicians | Non-Pharmacy Dispensing Site | 1721 W Canal St, Milwaukee, WI 53233 | 2018-07-26 |
| 1184170706 | Lauren Troll | Physical Therapist | 925 N 12th Street, Milwaukee, WI 53233 | 2016-09-01 |
| 1942694401 | Iryna Nemesh | Internal Medicine | 1020 N 12th St Fl 2, Milwaukee, WI 53233 | 2015-03-23 |
| 1649676032 | Matina Angelopoulou | Dentist | 1801 West Winsconsin Ave, Milwaukee, WI 53233 | 2014-11-12 |
| 1780007831 | John Ladisa | Technician, Other | 1637 W. Wisconsin Ave, Room 311, Milwaukee, WI 53233 | 2014-01-27 |
| Find all providers in zip 53233 | ||||
| Taxonomy Code | 3336S0011X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Specialty Pharmacy |
| A pharmacy that dispenses generally low volume and high cost medicinal preparations to patients who are undergoing intensive therapies for illnesses that are generally chronic, complex and potentially life threatening. Often these therapies require specialized delivery and administration. |
| 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 |
|---|---|---|---|---|
| 1881783777 | Froedtert Memorial Lutheran Hospital, Inc. | Pharmacy | 9200 W Wisconsin Ave, Suite 200w, Milwaukee, WI 53226-3522 | 2006-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265052211 | Dean Retail Services, Inc. | Pharmacy | 310 Integrity Dr, Madison, WI 53717-1416 | 2020-04-20 |
| 1730749672 | Depere Hometown Pharmacy LLC | Pharmacy | 510 Redbird Cir, De Pere, WI 54115-8785 | 2019-06-13 |
| 1356800361 | Sister Bay Hometown Pharmacy LLC | Pharmacy | 10578 Country Walk Dr Unit 27, Sister Bay, WI 54234-9114 | 2019-03-19 |
| 1669885471 | Wauwatosa Prescription Center, Inc. | Pharmacy | 4855 S Moorland Road, New Berlin, WI 53151 | 2014-06-09 |
| 1700974409 | Health Care Pharmacies, Inc | Pharmacy | 252 State Highway 70 E, Saint Germain, WI 54558-8800 | 2006-10-10 |
| 1114960994 | Glendale Prescription Center Inc | Pharmacy | 5322 N Port Washington Rd, Glendale, WI 53217-4913 | 2006-06-13 |
| 1730121039 | Md Group II LLC | Pharmacy | 1101 Hwy 69 Ste 7, New Glarus, WI 53574 | 2006-06-12 |
| 1992751143 | Corner Drug Store, Inc | Pharmacy | 316 W Spring St Ste 6, Dodgeville, WI 53533-1300 | 2006-05-26 |
| 1912416991 | Algoma Hometown Pharmacy LLC | Pharmacy | 801 Jefferson St, Algoma, WI 54201-1733 | 2017-09-22 |
| 1841739166 | Hemophilia Outreach Center | Pharmacy | 2060 Bellevue St, Green Bay, WI 54311-5622 | 2017-02-20 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on VERSITI WISCONSIN, INC..
| 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.