ERICKSONS DIVERSIFIED CORPORATION


Address: 107 Parent St, Somerset, WI 54025-7439
Phone: 6168782761

ERICKSONS DIVERSIFIED CORPORATION (NPI# 1720691454) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1720691454
Entity Type Organization
Organization Name ERICKSONS DIVERSIFIED CORPORATION
Practice Address 107 Parent St
Somerset
WI 54025-7439
Mailing Address 1527 Momentum Pl
Chicago
IL 60689-0001
Practice Telephone 6168782761
Enumeration Date 2020-08-24
Last Update Date 2020-08-24
Authorized Official Name EDDIE GARCIA (DIRECTOR OF PHARMACY)
Authorized Official Telephone 6168782975
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 333600000X Pharmacy Suppliers
Y 3336C0003X Pharmacy
Specialization: Community/Retail Pharmacy
Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
WI STATE LICENSE 9643-42 01

Other Provider/Organization Names

Other Name Type Code
ECONOFOODS PHARMACY #3324 Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1043368319 Ericksons Diversified Corporation Pharmacy 603 Division St S, Northfield, MN 55057-2426 2007-01-05
1134277403 Ericksons Diversified Corporation Pharmacy 951 E Frontage Rd, Litchfield, MN 55355-2613 2007-01-05
1952459224 Ericksons Diversified Corporation Pharmacy 612 S Minnesota Ave, Saint Peter, MN 56082-2100 2007-01-05
1194873000 Ericksons Diversified Corporation Pharmacy 623 Main St, Red Wing, MN 55066-2249 2007-01-08
1114075488 Ericksons Diversified Corporation Pharmacy 110 W 4th St, New Richmond, WI 54017-1722 2007-01-05
1841348117 Ericksons Diversified Corporation Pharmacy 303 S Main St, River Falls, WI 54022-2468 2007-01-05
1861540130 Ericksons Diversified Corporation Pharmacy 115 Elm St, Farmington, MN 55024-1033 2007-01-05
1669520938 Ericksons Diversified Corporation Pharmacy 2351 Coulee Rd, Hudson, WI 54016-9177 2007-01-05

Office Location

Street Address 107 PARENT ST
City SOMERSET
State WI
Zip Code 54025-7439

Providers in the same location

NPI Name Taxonomy Address Enumeration
1437334109 Bobrowski Industries Co Pharmacy 107 Parent St, Somerset, WI 54025-7439 2007-12-31

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1992987440 School District of Somerset Local Education Agency (LEA) 645 Sunrise Dr, Somerset, WI 54025 2007-11-27
1164619011 Rodney Alan Franks Chiropractor 2110 Cook Dr, Somerset, WI 54025 2007-09-25
1407985443 Christopher Arlen Rud Chiropractor 705 Rivard Street, Suite 3, Somerset, WI 54025 2007-03-05
1689757080 St Croix Valley Dental Pllc Dentist 705 Rivard St, Somerset, WI 54025 2006-10-23
1710352653 Kyle Ruhde Specialist/Technologist 645 Sunrise Dr, Somerset, WI 54025 2015-12-03
1215305412 Group Health Plan Inc Family Medicine 700 Rivard St, Somerset, WI 54025 2015-09-04
1952731986 Suzanne M. Carlson-shimon Nurse Practitioner 700 Rivard St, Somerset, WI 54025 2013-11-12
1841851888 Stephanie Prichett Physical Therapist 709 Rivard St, Somerset, WI 54025-1402 2019-06-20
1174005045 Holly Huso Physical Therapist 709 Rivard St, Somerset, WI 54025-1402 2018-09-06
1730683327 Justin Scheierl Physical Therapist 709 Rivard St, Somerset, WI 54025-1402 2018-03-20
Find all providers in zip 54025

Taxonomy Information

Taxonomy Code 3336C0003X
Grouping Suppliers
Classification Pharmacy
Specialization Community/Retail Pharmacy

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1245848993 Plaza Pharmacy Corp Pharmacy 84 Veronica Ave Ste A107, Somerset, NJ 08873-3529 2020-07-20
1376833970 Medicine Shoppe Long Term Care Pharmacy 900 E Mount Vernon St Unit B, Somerset, KY 42501-1228 2011-04-15
1407027154 Drug Fair Group, Inc. Pharmacy 800 Cottontail Ln, Somerset, NJ 08873-1227 2008-03-20
1437334109 Bobrowski Industries Co Pharmacy 107 Parent St, Somerset, WI 54025-7439 2007-12-31
1356532352 Goforth Pharmacy LLC Pharmacy 406 Bogle St, Somerset, KY 42503 2007-08-05
1144361569 Century Pharmacy, Inc. Pharmacy 875 South Highway 27, Somerset, KY 42501 2007-02-09
1134212582 Genmar.eb Inc. Pharmacy 131 S Pleasant Ave, Somerset, PA 15501-2189 2006-09-30
1154421584 Cvs Pharmacy Inc Pharmacy 1587 Brayton Point Rd, Somerset, MA 02725 2006-09-25
1659474393 Kentucky Cvs Pharmacy, L.L.C. Pharmacy 144 N Highway 27, Somerset, KY 42503-1732 2006-09-07
1730282583 Pennsylvania Cvs Pharmacy LLC Pharmacy 110 S Pleasant Ave, Somerset, PA 15501-2193 2006-09-07
Find all providers in SOMERSET

Competitor

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City SOMERSET
Zip Code 54025

Improve Information

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Dataset Information

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.

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