JUSTIN C STAKSTON (NPI# 1174933295) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174933295 |
| Entity Type | Individual |
| Full Name | JUSTIN C STAKSTON |
| Credential | PHARMD, BCPS |
| Practice Address |
2400 Rose St La Crosse WI 54603-1612 |
| Practice Telephone | 6087813300 |
| Mailing Telephone | 6087813300 |
| Enumeration Date | 2014-04-28 |
| Last Update Date | 2014-04-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P1200X |
Pharmacist Specialization: Pharmacotherapy |
14519-40 | WI | Pharmacy Service Providers |
| Street Address |
2400 ROSE ST |
| City | LA CROSSE |
| State | WI |
| Zip Code | 54603-1612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790731438 | Shopko Stores Operating Co LLC | Pharmacy | 2400 Rose St, La Crosse, WI 54603-1612 | 2006-05-25 |
| 1194158865 | John Patrick Smieja | Pharmacist | 2400 Rose St, La Crosse, WI 54603 | 2013-08-16 |
| 1316388499 | Trisha Stroyny | Pharmacist | 2400 Rose St, La Crosse, WI 54603-1612 | 2013-07-17 |
| 1639510209 | Anita Lindvig | Pharmacist | 2400 Rose St, La Crosse, WI 54603-1612 | 2013-07-11 |
| 1417393315 | Rhonda Wine | Pharmacist | 2400 Rose St, La Crosse, WI 54603-1612 | 2013-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215581855 | Sophia Buchda | Behavior Technician | 901 Caledonia Street, La Crosse, WI 54603 | 2019-08-01 |
| 1891142865 | Hha of Wisconsin, LLC | Home Health | 2400 Rose St Ste 14, La Crosse, WI 54603 | 2016-05-19 |
| 1225415540 | Alexander Blaschke | Podiatrist | 1009 Caledonia St, La Crosse, WI 54603 | 2015-05-06 |
| 1982986345 | Christopher W Hutchinson | Pharmacist | 2626 Rose Street, La Crosse, WI 54603 | 2011-09-12 |
| 1932284494 | Vision World Inc | Eyewear Supplier (Equipment, not the service) | 3800 State Road 16, La Crosse, WI 54603 | 2006-10-25 |
| 1083618722 | Teddy Leonard Thompson | Family Medicine | 1526 Rose Street, La Crosse, WI 54603 | 2005-06-10 |
| 1518459155 | Alexis Ericson | Occupational Therapy Assistant | 901 Caledonia St, La Crosse, WI 54603 | 2018-05-30 |
| 1578925046 | Vicki Lynne Iverson | Registered Nurse | 1407 St. Andrew St., La Crosse, WI 54603 | 2016-03-24 |
| 1275726663 | Jacqueline Berry Newcomb | Case Manager/Care Coordinator | 1407 St Andrew St, Suite 100 Lacrosse Co Human Services, La Crosse, WI 54603 | 2007-08-20 |
| 1164624920 | Kimberly Ann Connor | Case Manager/Care Coordinator | 1407 St Andrew St, Suite 100, La Crosse, WI 54603 | 2007-06-04 |
| Find all providers in zip 54603 | ||||
| Taxonomy Code | 1835P1200X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacotherapy |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in optimizing pharmacotherapeutic care of patients, by developing, implementing, monitoring, and modifying complex treatment plans, providing advanced level education and consultation, and collaborating with other health professionals in the management of therapy. |
| Notes: Source: Specialty certification and recertification program administered by Board of Pharmaceutical Specialties, www.bpsweb.org [7/1/2006: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295123735 | Nate Smith | Pharmacist | 2536 Kendall Ave, Madison, WI 53705-3847 | 2015-01-07 |
| 1710382809 | Betsy Hoida | Pharmacist | 2485 Greenbrier Rd., Green Bay, WI 54311 | 2014-10-31 |
| 1497187181 | Sarah J Wilczek | Pharmacist | 699 S Green Bay Rd, Neenah, WI 54956-3153 | 2013-08-05 |
| 1528311206 | Meaghan A Mcmurray | Pharmacist | 10932 N Port Washington Rd, Mequon, WI 53092-5031 | 2012-10-18 |
| 1417225731 | Lisa Marie Mlodzik | Pharmacist | 1316 30th Ct, Kenosha, WI 53144-3064 | 2011-12-01 |
| 1083891584 | Tricia Lyn Dissmore | Pharmacist | 806 Greenwood St, Holmen, WI 54636-8003 | 2008-01-28 |
| 1477608354 | Allan T. Mailloux | Pharmacist | 10 E Doty St Ste 210, Madison, WI 53703-3354 | 2007-01-24 |
| 1518062884 | Kristin Ann Higgins | Pharmacist | 726 London Rd, Deerfield, WI 53531-9572 | 2006-09-13 |
| 1295849420 | Brian D Schafer | Pharmacist | 129 Old Abe Road, Lac Du Flambeau, WI 54538 | 2006-08-17 |
| 1619985983 | Anthony G Staresinic | Pharmacist | 2650 Novation Pkwy, Suite 400, Madison, WI 53713-3399 | 2006-08-03 |
| 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.