IV COMPOUND CENTER OF WISCONSIN LLC (NPI# 1487997235) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487997235 |
| Entity Type | Organization |
| Organization Name | IV COMPOUND CENTER OF WISCONSIN LLC |
| Practice Address |
5478 S Westridge Dr New Berlin WI 53151-7948 |
| Practice Telephone | 2626412850 |
| Practice Fax Number | 2626412854 |
| Mailing Telephone | 2626412850 |
| Mailing Fax Number | 2626412854 |
| Enumeration Date | 2013-03-30 |
| Last Update Date | 2013-03-30 |
| Authorized Official Name | MR. DONALD STEVEN KOSHAK (OWNER) |
| Authorized Official Telephone | 2626412850 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
8543-042 | WI | Suppliers |
| Street Address |
5478 S WESTRIDGE DR |
| City | NEW BERLIN |
| State | WI |
| Zip Code | 53151-7948 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023459484 | Prnrx | Pharmacist | 5478 S Westridge Dr, Suite B, New Berlin, WI 53151-7948 | 2013-07-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629527486 | Natural Look Salon and Wigs LLC | Durable Medical Equipment & Medical Supplies | 4805 S. Moorland Rd, New Berlin, WI 53151 | 2016-09-22 |
| 1396193033 | New Berlin Medical Services, LLC | Clinic/Center | 15324 W Beloit Road, New Berlin, WI 53151 | 2016-06-02 |
| 1063899680 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 15300 West Grange Avenue, New Berlin, WI 53151 | 2015-05-04 |
| 1871970368 | Mary Spath | Physical Therapy Assistant | 2810 South Acredale Road, New Berlin, WI 53151 | 2015-05-04 |
| 1669885471 | Wauwatosa Prescription Center, Inc. | Pharmacy | 4855 S Moorland Road, New Berlin, WI 53151 | 2014-06-09 |
| 1750711446 | Pure Family Chiropractic LLC | Chiropractor | 3504 S. Moorland Road, New Berlin, WI 53151 | 2013-11-18 |
| 1336578202 | Hamilton John Dowden | Chiropractor | 3504 S Moorland Rd, New Berlin, WI 53151 | 2013-11-01 |
| 1053653618 | Danielle Lynn Lucio | Acupuncturist | 15807 W. National Ave., New Berlin, WI 53151 | 2013-03-21 |
| 1306195110 | Marlena J Friedrich | Registered Nurse | 1709 S. 171st Street, New Berlin, WI 53151 | 2012-09-07 |
| 1548519176 | Patricia M Friedrich | Licensed Practical Nurse | 1709 So. 171st Street, New Berlin, WI 53151 | 2012-08-29 |
| Find all providers in zip 53151 | ||||
| Taxonomy Code | 3336C0004X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Compounding Pharmacy |
| A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner’s Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice. |
| Notes: Sources: NABP Model Practice Act, Appendix C - Good Compounding Practice, USP <795> and <797>, and Pharmacy Compounding Accreditation Board [7/1/2006: new] |
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|---|---|---|---|---|
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| 1396049706 | Ltc Rx Inc | Pharmacy | 13 E Spruce St Ste 102, Chippewa Falls, WI 54729-2579 | 2010-12-28 |
| 1700025707 | Allergychoices Inc | Pharmacy | 2731 National Dr, Onalaska, WI 54650-8784 | 2009-02-13 |
| 1811043870 | Women's International Pharmacy | Pharmacy | 2 Marsh Ct, Madison, WI 53718-8805 | 2007-01-25 |
| 1871679530 | Waukesha Prescription Center Ltd | Pharmacy | 501 S. Grand Ave., Waukesha, WI 53186 | 2006-10-27 |
| 1386756203 | Manitowoc Pharmacies Inc | Pharmacy | 630 Fremont St, Kiel, WI 53042-1321 | 2006-08-31 |
| 1578109161 | Aurora Pharmacy Inc | Pharmacy | 210 S Pine St, Burlington, WI 53105-1914 | 2019-11-19 |
| 1891132999 | Thrive Health Center Pharmacy | Pharmacy | 831 Critter Ct, Suite 300, Onalaska, WI 54650-8674 | 2013-05-29 |
| 1750673919 | Restore Health Pharmacy, LLC | Pharmacy | 1289 Deming Way, Madison, WI 53717-2007 | 2011-05-06 |
| Find all providers with the same taxonomy | ||||
| City | NEW BERLIN |
| Zip Code | 53151 |
Please comment or provide details below to improve the information on IV COMPOUND CENTER OF WISCONSIN LLC.
| 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.