NPIMap

Organization Active NPI

Micklesen Drug Inc

  • Long Term Care Pharmacy
  • Hudson, WI
National Provider Identifier
1033657283
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
4862-42 Issued in WI
Legal business name
MICKLESEN DRUG INC
Practice address
530 2ND St
Hudson, WI 54016-1799
Phone
(715) 386-3344
Fax
(715) 386-5198
NPI assigned
Feb 8, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Authorized official

Name
Mark AndersonNPI 1376635425
Title
Pharmacist
Phone
(715) 386-3344

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Long Term Care Pharmacy 3336L0003X 4862-42 WI Primary

Addresses

Primary practice location

530 2ND St
Hudson, WI 54016-1799

Mailing address

530 2ND St
Hudson, WI 54016-1799
Phone (715) 386-3344

Other identifiers 2

IdentifierTypeStateIssuer
33003000MedicaidWI
2167180OtherPK

Other names 1

  • MICKLESEN DRUG Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Micklesen Drug Inc530 2ND St, Hudson, WI 54016-1512(715) 386-3344 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Nebulizer Equipment and/or Supplies Accepts assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
Micklesen Drug2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1486512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1033657283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 2ND ST",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540161799",
            "telephone_number": "715-386-3344",
            "fax_number": "715-386-5198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 2ND ST",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540161799",
            "telephone_number": "715-386-3344",
            "fax_number": "715-386-5198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICKLESEN DRUG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-08",
        "last_updated": "2025-09-19",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "715-386-3344"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "WI",
            "license": "4862-42",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33003000",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2167180",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MICKLESEN DRUG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hudson, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.