WISCONSIN CVS PHARMACY LLC (NPI# 1285989178) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285989178 |
| Entity Type | Organization |
| Organization Name | WISCONSIN CVS PHARMACY LLC |
| Other Organization Name | CVS PHARMACY 02214 |
| Practice Address |
800 Main Ave Depere WI 54115 |
| Mailing Address |
1 Cvs Dr Box 1075 - Pharmacy Enrollments Woonsocket RI 02895-6146 |
| Practice Telephone | 9203366373 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2012-11-09 |
| Authorized Official Name | SUSAN COLBERT (DIRECTOR PAYER RELATIONS) |
| Authorized Official Telephone | 4017702751 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | PHARMACY STATE LICENSE | 9158 | 01 |
| WI | 1285989178 | 05 | |
| NCPDP | 5133246 | 01 | |
| DEA | FW3463368 | 01 |
| Other Name | Type Code |
|---|---|
| CVS PHARMACY 02214 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508299926 | Wisconsin Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1736 W. 9th Ave., Oshkosh, WI 54902 | 2013-08-21 |
| 1194158303 | Wisconsin Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1700 Milton Ave., Janesville, WI 53545-0833 | 2013-08-12 |
| 1407298383 | Wisconsin Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2410 8th St S, Wisconsin Rapids, WI 54494-6159 | 2013-07-22 |
| 1831537869 | Wisconsin Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 102 Central Bridge St, Wausau, WI 54401-2944 | 2013-06-12 |
| 1376899120 | Wisconsin Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 4301 W Wisconsin Ave Ste 42, Appleton, WI 54913-6524 | 2012-07-31 |
| 1225398738 | Wisconsin Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 12725 W Bluemound Rd, Brookfield, WI 53005-8032 | 2012-05-18 |
| 1396014908 | Wisconsin Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | N83 W15550 Appleton Avenue, Menomonee Falls, WI 53051 | 2011-12-28 |
| 1467720037 | Wisconsin Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 6701 Mineral Point Road, Madison, WI 53705-4241 | 2011-12-09 |
| 1225305865 | Wisconsin Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 7552 W. Oklahoma Ave., West Allis, WI 53219-2860 | 2011-11-28 |
| 1952678591 | Wisconsin Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 605 W. Cottage Grove Rd., Cottage Grove, WI 53527-9222 | 2011-11-28 |
| Street Address |
800 MAIN AVE |
| City | DEPERE |
| State | WI |
| Zip Code | 54115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871138073 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 723 Main Ave, Depere, WI 54115 | 2019-11-12 |
| 1568928083 | Stephanie J Towle | Speech-Language Pathologist | 200 S. 9th St, De Pere, WI 54115 | 2019-02-20 |
| 1164988499 | Maribel L Zoeller | Physical Therapy Assistant | 200 S. 9th Street, Depere, WI 54115 | 2019-02-12 |
| 1255897641 | Elizabeth Eberius | Acupuncturist | 3311 S. Packerland Drive, Suite A #20, De Pere, WI 54115 | 2019-02-11 |
| 1548750458 | Jordyn E Arndt | Physical Therapist | 1601 Lawrence Dr Ste 100, De Pere, WI 54115 | 2018-05-16 |
| 1588153514 | David Nowakowski | Registered Nurse | 158 Cavil Way, De Pere, WI 54115 | 2018-05-04 |
| 1457858557 | Rennes Assisted Living Corp. | Assisted Living Facility | 1150 Lois Street, Depere, WI 54115 | 2018-04-06 |
| 1518473966 | Kirsten Lynne Masrelian | Behavioral Analyst | 2073 Lawrence Dr, De Pere, WI 54115 | 2017-12-21 |
| 1285146050 | Sydney Marie Schultz | Physical Medicine & Rehabilitation | 200 S. Ninth Street, De Pere, WI 54115 | 2017-11-01 |
| 1134666514 | Nicole L Bickham | Psychologist | 416 George St Ste 108, De Pere, WI 54115 | 2017-01-24 |
| Find all providers in zip 54115 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| 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: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497355002 | Long Life Pharmacy 2 LLC | Pharmacy | 1225 W Historic Mitchell St Ste 217, Milwaukee, WI 53204-3382 | 2020-11-01 |
| 1710527783 | Sage Specialty Pharmacy Inc. | Pharmacy | 4001 N. Oakland Ave, Shorewood, WI 53211 | 2020-01-08 |
| 1790333623 | Froedtert Health Pharmacy LLC | Pharmacy | 9200 W Wisconsin Ave Ste 200w, Milwaukee, WI 53226-3522 | 2019-09-04 |
| 1225686405 | Froedtert Health Pharmacy LLC | Pharmacy | 9200 W Wisconsin Ave Ste 200c, Milwaukee, WI 53226-3522 | 2019-08-30 |
| 1134777337 | Froedtert Health Pharmacy LLC | Pharmacy | 11430 N Port Washington Rd Ste 103, Mequon, WI 53092-3414 | 2019-08-30 |
| 1619524766 | University Rx LLC | Pharmacy | 133 E College Ave, Appleton, WI 54911 | 2019-08-23 |
| 1053967026 | Accurabenefits, LLC | Pharmacy | 2413 Woodland Ter, Neenah, WI 54956-4824 | 2019-08-14 |
| 1184276917 | St. Clare Health Mission Pharmacy | Pharmacy | 916 Ferry St, La Crosse, WI 54601-4717 | 2019-07-11 |
| 1851851141 | Dean Retail Services, Inc. | Pharmacy | 740 Reena Ave Ste 300, Fort Atkinson, WI 53538-3145 | 2019-03-22 |
| 1093287237 | Del Mar Pharmacy Sc | Pharmacy | 1000 S Cesar E Chavez Dr, Milwaukee, WI 53204-2203 | 2018-12-28 |
| 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.