E.a. McCullough, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

4700 Issued in WI

Legal business name

E.A. MCCULLOUGH, INC.

Practice address

269 Broad St
Lake Geneva, WI 53147-1809

Phone

(262) 248-6226

NPI assigned

Aug 29, 2006

Organization subpart

No

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

Authorized official

Name

Mr. James Edward McCullough, RPH

Title

President

Phone

(262) 248-6226

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• McCullough's Prescriptions and Gifts Doing business as

Locations

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202083200000",
    "number": "1043329824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "694 S WELLS ST",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531472106",
            "telephone_number": "262-248-8582",
            "fax_number": "262-248-8593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 BROAD ST",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531471809",
            "telephone_number": "262-248-6226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E.A. MCCULLOUGH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2008-02-04",
        "status": "A",
        "authorized_official_last_name": "MCCULLOUGH",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-248-6226",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "4700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33108300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McCullough's Prescriptions and Gifts",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Madalyn R Douglas, DPT
• Dr. Daniel Bishop
• Mark R. Dvorak, CRNA
• E Bruns Foot and Ankle SC
• E. Bruns Foot & Ankle, SC
• Erika Eiesland, PT, DPT
• Dina A Eisel, LPN
• Natalie J Ellingson, PAC
• Frank J Elmudesi, PSYD
• Jonathan Erickson, M.D.

• Community/Retail Pharmacy in Lake Geneva, WI
• Providers in Lake Geneva, WI by specialty
• Community/Retail Pharmacy in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.