WISCONSIN VETERANS HOME PHCY (NPI# 1235151267) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235151267 |
| Entity Type | Organization |
| Organization Name | WISCONSIN VETERANS HOME PHCY |
| Other Organization Name | WISCONSIN VETERANS HOME PHARMACY |
| Practice Address |
N2665 County Road Qq King WI 54946-0600 |
| Practice Telephone | 7152581674 |
| Practice Fax Number | 7152583327 |
| Mailing Telephone | 7152581674 |
| Mailing Fax Number | 7152583327 |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2018-05-10 |
| Authorized Official Name | DANIEL A CHASE (SUPERVISOR) |
| Authorized Official Telephone | 7152565123 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
5568 | WI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 5112379 | 05 | |
| PK | 2113651 | 01 |
| Other Name | Type Code |
|---|---|
| WISCONSIN VETERANS HOME PHARMACY | Doing Business As Name - Organization |
| Street Address |
N2665 COUNTY ROAD QQ |
| City | KING |
| State | WI |
| Zip Code | 54946-0600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366439986 | State of Wisconsin | Skilled Nursing Facility | N2665 County Road Qq, King, WI 54946 | 2005-09-29 |
| 1841851268 | Danielle Kaufert | Physical Therapy Assistant | N2665 County Road Qq, King, WI 54946-0600 | 2019-06-26 |
| 1992201578 | Melissa R Duberstein | Occupational Therapy Assistant | N2665 County Road Qq, King, WI 54946-0600 | 2018-04-03 |
| 1073029286 | Ashley Caves | Speech-Language Pathologist | N2665 County Road Qq, King, WI 54946-0600 | 2017-12-26 |
| 1558803007 | Cynthia Ann Rendall | Nurse Practitioner | N2665 County Road Qq, King, WI 54946-0600 | 2016-11-15 |
| 1568738029 | Lisa Lebouef | Speech-Language Pathologist | N2665 County Road Qq, Speech Therapy Department, King, WI 54946-0600 | 2012-03-29 |
| 1134400401 | Amie Anna Lee Greely | Physical Therapy Assistant | N2665 County Road Qq, King, WI 54946-0600 | 2011-08-31 |
| 1346538352 | Robin Lynn Delgado | Speech-Language Pathologist | N2665 County Road Qq, King, WI 54946-0600 | 2011-07-12 |
| 1205143542 | Jodi Ann Dailey | Nurse Practitioner | N2665 County Road Qq, King, WI 54946-0600 | 2010-09-08 |
| 1982846283 | James Alan Lebouef | Dentist | N2665 County Road Qq, Wisconsin Veterans Home/ Dental Clinic, King, WI 54946-0600 | 2009-04-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376653261 | Paul Joseph Drinkt | Internal Medicine | N2665 County Rd Qq, Wisconsin Veterans Home, King, WI 54946 | 2006-08-30 |
| 1306861836 | Barbara A Bergman | Licensed Practical Nurse | N2665 Highway Qq, Wisconsin Veterans Home Pharmacy, King, WI 54946 | 2006-07-13 |
| 1093891046 | Dean M Christensen | Pharmacist | N2665 County Rd Qq, King, WI 54946-0600 | 2006-10-31 |
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922646579 | Medical Health Pharmacy LLC | Pharmacy | 8845 S Greenview Dr Ste 1, Middleton, WI 53562-2562 | 2019-12-13 |
| 1124665336 | Ltc Pharmacy Services, LLC | Pharmacy | 11739 W Bradley Rd, Milwaukee, WI 53224 | 2019-12-06 |
| 1487205944 | Hayat Pharmacy 20 LLC | Pharmacy | 805 W. Layton Ave., Suite B, Milwaukee, WI 53221 | 2019-09-26 |
| 1568015022 | T A Solberg Co Inc | Pharmacy | 232 S Courtney St Stop 3, Rhinelander, WI 54501-3308 | 2019-07-23 |
| 1932679081 | Janesville Hometown Pharmacy LLC | Pharmacy | 21 S Jackson St Ste 100, Janesville, WI 53548-3859 | 2018-12-03 |
| 1902371107 | Salvanz Enterprises Inc | Pharmacy | 2673 Lineville Rd, Green Bay, WI 54313-7124 | 2018-10-04 |
| 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.