MODERN APOTHECARY, LLC (NPI# 1407265598) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407265598 |
| Entity Type | Organization |
| Organization Name | MODERN APOTHECARY, LLC |
| Other Organization Name | MODERN APOTHECARY |
| Practice Address |
4924 7th Ave Kenosha WI 53140-3349 |
| Practice Telephone | 2629979573 |
| Practice Fax Number | 2629979574 |
| Mailing Telephone | 2629979573 |
| Mailing Fax Number | 2629979574 |
| Enumeration Date | 2014-08-04 |
| Last Update Date | 2017-01-03 |
| Authorized Official Name | ERIN E MERRITT (OWNER) |
| Authorized Official Telephone | 2629979573 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | 9274-42 | WI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP NUMBER | 5134476 | 01 |
| Other Name | Type Code |
|---|---|
| Modern Apothecary | Doing Business As Name - Organization |
| Street Address |
4924 7TH AVE |
| City | KENOSHA |
| State | WI |
| Zip Code | 53140-3349 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164654695 | Erin Merritt | Pharmacist | 4924 7th Ave, Kenosha, WI 53140-3349 | 2009-08-17 |
| 1306330592 | Megan Jeanne Sinnen | Pharmacist | 4924 7th Ave, Kenosha, WI 53140-3349 | 2018-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225663396 | Lydia Zopf | Counselor | 2001 Alford Park Dr., Carthage College, Kenosha, WI 53140 | 2020-03-09 |
| 1952949406 | Rotate Rehabilitation and Performance | Physical Therapist | 5606 6th Avenue Suite Ll9, Kenosha, WI 53140 | 2019-12-16 |
| 1134778590 | Brenda Chiapetta | Registered Nurse | 3233 23rd Ave, Kenosha, WI 53140 | 2019-09-09 |
| 1275003394 | Kimberly Shaffner | Family Medicine | 4536 22nd Avenue, Kenosha, WI 53140 | 2018-12-01 |
| 1659863389 | Bart L Mengo | Contractor | 1715 60th Street, Kenosha, WI 53140 | 2018-05-30 |
| 1093182941 | Guided Wellness Counseling | Community/Behavioral Health | 1112 56th St, Kenosha, WI 53140 | 2015-08-26 |
| 1376970764 | Stacey L Andersen | Acupuncturist | 5603 7th Ave, Kenosha, WI 53140 | 2013-10-01 |
| 1841467438 | Deborah Schwerdtfeger | Occupational Therapy Assistant | 3415 Sheridan Road, Woodstock Rehab Dept, Kenosha, WI 53140 | 2008-05-13 |
| 1942492020 | Rebecca Ann Burdette | Counselor | 920 60th Street, Renosha, WI 53140 | 2007-08-13 |
| 1851598619 | Aurora Medical Group, Inc. | Durable Medical Equipment & Medical Supplies | 2707 15th Place, Kenosha, WI 53140 | 2007-06-27 |
| Find all providers in zip 53140 | ||||
| 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 |
|---|---|---|---|---|
| 1245559301 | B7 Pharmacy Inc | Pharmacy | 9916 75th St Ste 103, Kenosha, WI 53142-7583 | 2010-05-27 |
| 1093840886 | Aurora Pharmacy, Inc | Pharmacy | 7014 Green Bay Rd, Kenosha, WI 53142-1435 | 2007-02-22 |
| 1992853253 | Roundys Supermarkets Inc | Pharmacy | 5710 75th St, Kenosha, WI 53142-3635 | 2007-01-05 |
| 1336653674 | Reliable Pharmacy of Wisconsin LLC | Pharmacy | 10105 74th St Ste 102, Kenosha, WI 53142-7519 | 2017-11-22 |
| 1659718153 | Jessica R Serpe | Pharmacy | 5300 52nd St, Kenosha, WI 53144-2310 | 2013-05-24 |
| 1841468428 | Aurora Pharmacy, Inc | Pharmacy | 2707 15th Place, Suite 101, Kenosha, WI 53140 | 2008-02-15 |
| 1326094772 | Shopko Stores Operating Co LLC | Pharmacy | 5300 52nd St, Kenosha, WI 53144-2310 | 2006-05-26 |
| 1821044744 | American Drug Stores LLC | Pharmacy | 7014 Green Bay Rd, Kenosha, WI 53142-1435 | 2006-05-25 |
| 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.