MD GROUP II LLC (NPI# 1356383822) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356383822 |
| Entity Type | Organization |
| Organization Name | MD GROUP II LLC |
| Other Organization Name | RANDOLPH HOMETOWN PHARMACY |
| Practice Address |
107 N High St Randolph WI 53956-1267 |
| Mailing Address |
333 Lowville Rd Rio WI 53960-9437 |
| Practice Telephone | 9203265242 |
| Practice Fax Number | 9203263765 |
| Mailing Telephone | 9209926800 |
| Mailing Fax Number | 9209926801 |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2020-03-12 |
| Authorized Official Name | DIANE L DEANS (CONTRACTING SPECIALIST) |
| Authorized Official Telephone | 9209926800 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
8437042 | WI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 33269600 | 05 | |
| NCPDP PROVIDER IDENTIFICATION NUMBER | 5108940 | 01 |
| Other Name | Type Code |
|---|---|
| RANDOLPH HOMETOWN PHARMACY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336254382 | Md Group II LLC | Durable Medical Equipment & Medical Supplies | 317 N Us Highway 51, Poynette, WI 53955-9344 | 2006-08-20 |
| 1356383699 | Md Group II LLC | Durable Medical Equipment & Medical Supplies | 208 Lincoln Ave, Rio, WI 53960-8015 | 2006-06-12 |
| 1730121039 | Md Group II LLC | Pharmacy | 1101 Hwy 69 Ste 7, New Glarus, WI 53574 | 2006-06-12 |
| 1043480296 | Md Group II LLC | Durable Medical Equipment & Medical Supplies | 117 N Main St, Pardeeville, WI 53954-8005 | 2008-03-04 |
| 1669416905 | Md Group II LLC | Durable Medical Equipment & Medical Supplies | 202 S Main St, Verona, WI 53593-1422 | 2006-06-16 |
| Street Address |
107 N HIGH ST |
| City | RANDOLPH |
| State | WI |
| Zip Code | 53956-1267 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326333006 | Michelle Dreger | Pharmacist | 107 N High St, Randolph, WI 53956-1267 | 2011-06-10 |
| 1316020241 | Rachael Ann Donatelle | Pharmacist | 107 N High St, Randolph, WI 53956-1267 | 2006-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194778324 | Shannon N Sandstrom | Nurse Practitioner | 137 Cambria St, Randolph, WI 53956 | 2006-05-18 |
| 1336102169 | Melissa Elaine Lucarelli | Family Medicine | 504 S High Street, Randolph, WI 53956 | 2006-04-11 |
| 1811039761 | Consultants Laboratory of Wi, LLC | Clinical Medical Laboratory | 137 Cambria St, Randolph, WI 53956 | 2007-02-13 |
| 1497832257 | Randolph Community Clinic Sc | Family Medicine | 504 S High Street, Randolph, WI 53956 | 2006-11-01 |
| 1770529828 | Agnesian Healthcare | Durable Medical Equipment & Medical Supplies | 137 Cambria St, Randolph, WI 53956 | 2006-06-20 |
| 1962052548 | Tessa Lindner | Physical Therapist | 502 N High St, Randolph, WI 53956-1117 | 2019-09-16 |
| 1245646645 | Rebecca Yelle | Occupational Therapist | 509 Williams St, Randolph, WI 53956-1122 | 2014-07-07 |
| 1003959529 | James Leslie Jones | Chiropractor | 175 Stark St, Randolph, WI 53956-1243 | 2007-02-14 |
| 1801955950 | Ross D Werner | Dentist | 125 N High St, Randolph, WI 53956-1267 | 2006-12-06 |
| 1457961971 | Myriel Jamae Werner | Dentist | 125 N High St, Randolph, WI 53956-1267 | 2020-08-10 |
| Find all providers in zip 53956 | ||||
| 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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| 1619221322 | Randolph Pharmacy | Pharmacy | 1187 N Main St, Randolph, MA 02368-2135 | 2012-11-01 |
| 1831417690 | Kph Healthcare Services, Inc. | Pharmacy | 151 Vermont Route 12 South, Randolph, VT 05060-9237 | 2010-05-04 |
| 1518065333 | New Jersey Cvs Pharmacy LLC | Pharmacy | 725 State Route 10, Randolph, NJ 07869 | 2006-09-20 |
| 1740899244 | Boston Medical Center Corporation | Pharmacy | 41 Teed Dr, Randolph, MA 02368-4201 | 2020-07-30 |
| 1750870820 | Weis Markets, Inc. | Pharmacy | 148 Center Grove Rd, Randolph, NJ 07869-1325 | 2018-05-04 |
| 1942348867 | Morris County Drugs Inc | Pharmacy | 477 Route 10 East, Randolph, NJ 07869 | 2007-02-02 |
| 1891894259 | Cvs Pharmacy Inc | Pharmacy | 171 N Main St, Randolph, MA 02368-4630 | 2006-09-22 |
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| 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 | ||||
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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.