NPIMap

Organization Active NPI

Pharmacare LTD

  • Community/Retail Pharmacy
  • Mondovi, WI
National Provider Identifier
1023110830
Registry record updated Nov 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
PHARMACARE LTD
Practice address
122 S Eau Claire St
Mondovi, WI 54755-1504
Phone
(715) 926-4938
Fax
(715) 926-5876
NPI assigned
Sep 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Brandin Henke
Title
Credentialing
Phone
(715) 833-6770

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Primary
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

122 S Eau Claire St
Mondovi, WI 54755-1504

Mailing address

122 S Eau Claire St
Mondovi, WI 54755-1504
Phone (715) 926-4938

Other identifiers 1

IdentifierTypeStateIssuer
33054100MedicaidWI

Other names 1

  • Mondovi Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930047826 WI DME Supplier - Pharmacy 4082829601 Practice locations: Mondovi, WI
O20120202000575 WI Part B Supplier - Mass Immunization (Roster Biller Only) 4082829601 10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Whitehall, WI; Bloomer, WI; Mondovi, WI; Barron, WI; Chetek, WI; Augusta, WI

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Pharmacare LTD10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636934400000",
    "number": "1023110830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 S EAU CLAIRE ST",
            "city": "MONDOVI",
            "state": "WI",
            "postal_code": "547551504",
            "telephone_number": "715-926-4938",
            "fax_number": "715-926-5876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 S EAU CLAIRE ST",
            "city": "MONDOVI",
            "state": "WI",
            "postal_code": "547551504",
            "telephone_number": "715-926-4938",
            "fax_number": "715-926-5876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMACARE LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-02",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A",
        "authorized_official_last_name": "HENKE",
        "authorized_official_first_name": "BRANDIN",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "715-833-6770"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33054100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mondovi Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mondovi, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.