13TH STREET PHARMACY LLC (NPI# 1679835326) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1679835326 |
Entity Type | Organization |
Organization Name | 13TH STREET PHARMACY LLC |
Other Organization Name | 13TH STREET PHARMACY LLC |
Practice Address |
1320 W Burnham St Milwaukee WI 53204-3248 |
Practice Telephone | 4143834111 |
Practice Fax Number | 4143832248 |
Mailing Telephone | 4143834111 |
Mailing Fax Number | 4143832248 |
Enumeration Date | 2012-06-08 |
Last Update Date | 2014-12-03 |
Authorized Official Name | RUSSEL SHTIVELBERG (MEMBER) |
Authorized Official Telephone | 4143249393 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
9131-42 | WI | Suppliers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
PK | 2135508 | 01 | |
WI | 100023902 | 05 |
Other Name | Type Code |
---|---|
13th Street Pharmacy LLC | Doing Business As Name - Organization |
Street Address |
1320 W BURNHAM ST |
City | MILWAUKEE |
State | WI |
Zip Code | 53204-3248 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851720718 | Eli Avrahami | Pharmacist | 1320 W Burnham St, Milwaukee, WI 53204-3248 | 2013-11-01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528423290 | Blue Ribbon Healthcare LLC | Health Maintenance Organization | 1743 South1st Street, Milwaukee, WI 53204 | 2015-12-23 |
1215336599 | Marsha Vann | Counselor | 1028 N 9th St, Milwaukee, WI 53204 | 2014-08-22 |
1891109260 | Melissa Bendever | Counselor | 1111 South 6th Street, Milwaukee, WI 53204 | 2014-06-13 |
1942585823 | Theresa Marie Hintze | Counselor | 600 W Virginia Atlas Ste 203, Milwaukee, WI 53204 | 2011-10-11 |
1922395151 | Palmas & Ram Rudra LLC | Chiropractor | 1247 S. Cesar E. Chaves Drive, Milwaukee, WI 53204 | 2011-07-08 |
1225355183 | Victoria A White | Family Medicine | 16th Street Community Health Center, 1032 S Cesar E. Chavez Drive, Milwaukee, WI 53204 | 2010-04-30 |
1174850499 | Dnt Associates Inc. | Dentist | 710 W. Historic Mitchell St., Mitchell Street Dental, Milwaukee, WI 53204 | 2009-11-06 |
1851559124 | Michael L Kitzinger | Social Worker | 1201 W Historic Mitchell St, Milwaukee, WI 53204 | 2008-05-23 |
1083778781 | Douglas Ralph Higbie | Psychologist | 634 W Mitchell St, Milwaukee, WI 53204 | 2006-12-20 |
1013019413 | Romeo C Lo Md | Internal Medicine | 1672 S 9th St, 2nd Floor, Milwaukee, WI 53204 | 2006-09-05 |
Find all providers in zip 53204 |
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 |
---|---|---|---|---|
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 |
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 |
1982257200 | Hayat Pharmacy 16 LLC | Pharmacy | 603 N 36th St, Milwaukee, WI 53208-3826 | 2019-07-17 |
1952965576 | Life Change Rx 1 LLC | Pharmacy | 813 S Layton Blvd, Milwaukee, WI 53215-1225 | 2019-04-29 |
1649706714 | Life Tree Pharmacy LLC | Pharmacy | 8329-5 W Appleton Ave, Milwaukee, WI 53218 | 2017-05-10 |
1366814980 | Hayat Pharmacy 7, LLC. | Pharmacy | 5312 W Villard Ave, Milwaukee, WI 53218-4345 | 2015-10-22 |
1689015521 | Roundys Supermarkets Inc | Pharmacy | 875 E Wisconsin Ave, Milwaukee, WI 53202-5404 | 2013-07-08 |
1962641514 | Roundys Supermarkets Inc | Pharmacy | 7401 W Good Hope Rd, Milwaukee, WI 53223-4618 | 2009-02-05 |
Find all providers in MILWAUKEE |
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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.