SAINT-MARK ENTERPRISES 1798 LLC (NPI# 1619114931) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1619114931 |
Entity Type | Organization |
Organization Name | SAINT-MARK ENTERPRISES 1798 LLC |
Other Organization Name | MEDICINE SHOPPE |
Practice Address |
300 Superior Avenue Tomah WI 54660 |
Mailing Address |
Po Box 98 Eureka MO 63025-0098 |
Practice Telephone | 6083722101 |
Mailing Telephone | 3145182427 |
Enumeration Date | 2009-01-08 |
Last Update Date | 2009-05-27 |
Authorized Official Name | MARK MILLER (OWNER) |
Authorized Official Telephone | 3145182427 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 332B00000X | Durable Medical Equipment & Medical Supplies | WI | Suppliers | |
Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NCPDP # | 5131355 | 01 | |
WI | 100002221 | 05 |
Other Name | Type Code |
---|---|
MEDICINE SHOPPE | Doing Business As Name - Organization |
Street Address |
300 SUPERIOR AVENUE |
City | TOMAH |
State | WI |
Zip Code | 54660 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255786281 | Jean Hinrichsen | Nurse Practitioner | 500 E Veterans Administration, Tomah, WI 54660 | 2016-04-27 |
1871994418 | Jennifer Annette Aeling | Psychologist | 500 E Veterans Street, Mh Admin, Tomah, WI 54660 | 2014-09-15 |
1003182346 | James Arthur Hennes | Psychiatric Unit | 515 Veterans St., Tomah, WI 54660 | 2012-03-30 |
1629259163 | Mark Frederick Mueller | Counselor | 324 Butts Avenue, Tomah, WI 54660 | 2007-11-26 |
1073713293 | Sheetal Reddy Marri | Psychiatry & Neurology | 5000 Veterans St., Tomah, WI 54660 | 2007-07-25 |
1528144946 | Kevin Albert Stagman | Optometrist | 222 West Mccoy Blvd, Tomah, WI 54660 | 2006-10-27 |
1346320058 | Eugenia S Durst | Nurse Practitioner | 500 East Veterans St, Tomah, WI 54660 | 2006-10-17 |
1962596536 | Angela Kay Fuller | Nurse Practitioner | 321 Butts Ave., Tomah Memorial Hospital, Tomah, WI 54660 | 2006-10-03 |
1285737767 | James John Blado | Dentist | 1116 Superior Ave, Superior Suites, Tomah, WI 54660 | 2006-09-07 |
1558476184 | Chitwood Nicol & Matthews LLC | Dentist | 214 Larkin St, Tomah, WI 54660 | 2006-08-21 |
Find all providers in zip 54660 |
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] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790879609 | Pharmacy Operations Inc | Pharmacy | 300 Superior Ave, Tomah, WI 54660 | 2006-10-03 |
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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.