THE PHARMACY OF NEW LONDON INC. (NPI# 1295847119) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295847119 |
| Entity Type | Organization |
| Organization Name | THE PHARMACY OF NEW LONDON INC. |
| Other Organization Name | JERNEGAN'S HEALTH MART PHARMACY |
| Practice Address |
1301 Mill St New London WI 54961-2153 |
| Practice Telephone | 9209827670 |
| Practice Fax Number | 9209827686 |
| Mailing Telephone | 9209827670 |
| Mailing Fax Number | 9209827686 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2015-03-22 |
| Authorized Official Name | JIM JERNEGAN (OWNER PHARMACIST) |
| Authorized Official Telephone | 9209827670 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | 6861 | WI | Suppliers |
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | DEA # | BM1209370 | 01 |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 5118698 | 01 | |
| WI | 33152900 | 05 |
| Other Name | Type Code |
|---|---|
| Jernegan's Health Mart Pharmacy | Doing Business As Name - Organization |
| Street Address |
1301 MILL ST |
| City | NEW LONDON |
| State | WI |
| Zip Code | 54961-2153 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326536525 | Thompsons Rx Wisconsin LLC | Pharmacy | 1301 Mill St, New London, WI 54961-2153 | 2018-04-24 |
| 1942703335 | Thompsons Rx Wisconsin LLC | Pharmacy | 1301 Mill St, New London, WI 54961-2153 | 2018-03-13 |
| 1780067116 | Benjamin T Plass | Pharmacist | 1301 Mill St, New London, WI 54961-2153 | 2015-07-02 |
| 1396099610 | Stephanie Buelow | Pharmacy Technician | 1301 Mill St, New London, WI 54961-2153 | 2012-11-08 |
| 1689928269 | James Lee Jernegan | Pharmacist | 1301 Mill St, New London, WI 54961-2153 | 2012-11-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407406408 | Cheryl Schneider | Technician | L 56 Northgate Estates, New London, WI 54961 | 2019-09-12 |
| 1861634719 | Rebecca L Kramer | Counselor | 315 Burton St, New London, WI 54961 | 2009-03-24 |
| 1598913501 | Marsha Ann Nytes | Licensed Practical Nurse | E8222 Weyawega Rd, New London, WI 54961 | 2008-09-03 |
| 1659585172 | Amanda L. Beck | Physical Therapy Assistant | 400 E. 4th Street, Manawa, WI 54961 | 2007-05-10 |
| 1366599433 | Griebenow Eyecare, S.c. | Optometrist | 105 Northridge Drive, New London, WI 54961 | 2007-01-04 |
| 1740822055 | Lauren Mae Flunker | Social Worker | E7475 Rawhide Rd, New London, WI 54961 | 2019-10-09 |
| 1063641249 | Forefront Dermatology, S.c. | Dermatology | 1620 N Shawano St, Suite C, New London, WI 54961 | 2009-07-08 |
| 1093982530 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | 1420 Algoma St, New London, WI 54961 | 2008-05-14 |
| 1821263849 | Mark Alan Tegtmeier | Counselor | E7475 Rawhide Rd, New London, WI 54961 | 2008-04-30 |
| 1194910489 | Laurie Mollenhauer | Physical Therapist | 1405 Mill St, New London, WI 54961 | 2007-09-10 |
| Find all providers in zip 54961 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| 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] |
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|---|---|---|---|---|
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| 1871787598 | Walgreen Co | Pharmacy | 981 N. Shawano St, New London, WI 54961-9380 | 2007-09-06 |
| 1972648905 | Pichelmeyers Inc | Pharmacy | 320 Wolf River Plz, New London, WI 54961-1237 | 2007-02-20 |
| 1043380470 | First Colony Corp | Pharmacy | 247 Newport Rd, New London, NH 03257 | 2006-11-09 |
| 1982203147 | Nutmeg Pharmacy New London LLC | Pharmacy | 345 Broad St, New London, CT 06320-3726 | 2020-10-20 |
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| 1851939037 | Ascension Wisconsin Pharmacy, Inc | Pharmacy | 10180 Washington Ave Ste 102, Mount Pleasant, WI 53177-1604 | 2019-12-18 |
| 1558906354 | Life Change Rx 4 LLC | Pharmacy | 6300 N 76th St Ste 246, Milwaukee, WI 53218-1208 | 2019-11-15 |
| 1285278978 | Life Change Rx 3 LLC | Pharmacy | 7115 W Capitol Dr, Milwaukee, WI 53216-2051 | 2019-11-05 |
| 1295377703 | Hayat Pharmacy 21 LLC. | Pharmacy | 2333 Northwestern Ave Ste 120, Racine, WI 53404-2520 | 2019-10-16 |
| 1487296737 | Xperience Pharmacy LLC | Pharmacy | 5715 W Appleton Ave, Milwaukee, WI 53210-2250 | 2019-10-08 |
| 1962053421 | Hayat Pharmacy 19 LLC | Pharmacy | 805 W. Layton Ave. Suite A, Milwaukee, WI 53221 | 2019-09-26 |
| 1275182925 | Walgreen Co | Pharmacy | 2265 N Mayfair Rd, Wauwatosa, WI 53226-2207 | 2019-09-05 |
| 1982257200 | Hayat Pharmacy 16 LLC | Pharmacy | 603 N 36th St, Milwaukee, WI 53208-3826 | 2019-07-17 |
| Find all providers with the same taxonomy | ||||
| City | NEW LONDON |
| Zip Code | 54961 |
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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.