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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 333600000X | Pharmacy | Suppliers | ||
Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WI | STATE LICENSE | 9643-42 | 01 |
Other Name | Type Code |
---|---|
ECONOFOODS PHARMACY #3324 | Doing Business As Name - Organization |
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 |
Street Address |
107 PARENT ST |
City | SOMERSET |
State | WI |
Zip Code | 54025-7439 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437334109 | Bobrowski Industries Co | Pharmacy | 107 Parent St, Somerset, WI 54025-7439 | 2007-12-31 |
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 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 |
---|---|---|---|---|
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 |
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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.