SISTER BAY HOMETOWN PHARMACY LLC (NPI# 1356800361) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356800361 |
| Entity Type | Organization |
| Organization Name | SISTER BAY HOMETOWN PHARMACY LLC |
| Practice Address |
10578 Country Walk Dr Unit 27 Sister Bay WI 54234-9114 |
| Mailing Address |
333 Lowville Rd Rio WI 53960-9437 |
| Practice Telephone | 9206334060 |
| Mailing Telephone | 9209926800 |
| Mailing Fax Number | 9209926801 |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2019-03-19 |
| Authorized Official Name | DIANE DEANS (CONTRACTING SPECIALIST) |
| Authorized Official Telephone | 9209926800 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| Other Name | Type Code |
|---|---|
| SISTER BAY HOMETOWN PHARMACY | Doing Business As Name - Organization |
| Street Address |
10578 COUNTRY WALK DR UNIT 27 |
| City | SISTER BAY |
| State | WI |
| Zip Code | 54234-9114 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790940674 | Thomas M Mayhew | Dentist | 10589 S Highland Dr, Ste 4, Sister Bay, WI 54234 | 2008-07-21 |
| 1598974990 | Elizabeth Ann Jorgenson | Chiropractor | 275 Smith Drive, Sister Bay, WI 54234 | 2007-05-22 |
| 1841404969 | C Thomas Wilson | Dentist | 703 S Bay Shore Dr, Suite #4, Sister Bay, WI 54234 | 2007-05-09 |
| 1013038207 | Northern Door Dental Sc | Dentist | 10589 S Highland Rd Ste 4, Sister Bay, WI 54234 | 2007-04-03 |
| 1992839641 | Martha L Coventry | Nurse Practitioner | 10539 Applewood Road, Sister Bay, WI 54234 | 2007-03-15 |
| 1215080080 | Deborah Marie Webber | Chiropractor | 803 S Bayshore Dr, Sister Bay, WI 54234 | 2007-01-18 |
| 1427163500 | Michael F Flood | Physician Assistant | 2521 S Bay Shore Dr, Sister Bay, WI 54234 | 2006-08-20 |
| 1699771345 | Timothy D. Tishler | Dentist | 2596 S. Bay Shore Dr., Sister Bay, WI 54234 | 2005-06-27 |
| 1821296146 | Daniel B Anderson | Dentist | 703 S Bay Shore Dr, Sister Bay, WI 54234 | 2007-07-09 |
| 1114049202 | Joan A. Traver,md | Internal Medicine | 10539 Applewood Rd, Sister Bay, WI 54234-9004 | 2007-04-06 |
| Find all providers in zip 54234 | ||||
| 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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| 1942816939 | The Duluth Clinic, Ltd. | Pharmacy | 204 Belknap St, Ste 100, Superior, WI 54880-2964 | 2020-09-16 |
| 1902417207 | Ipack Pharmacy LLC | Pharmacy | 17000 W North Ave Ste 108w, Brookfield, WI 53005-4423 | 2020-08-11 |
| 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 | SISTER BAY |
| Zip Code | 54234 |
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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.