Village Apothecary Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5998042 Issued in WI

Legal business name

VILLAGE APOTHECARY INC

Doing business as

The Village Apothecary

Practice address

110 W Main St
Campbellsport, WI 53010-2704

Phone

(920) 533-4012

Fax

(920) 533-4012

NPI assigned

Feb 2, 2007

Last updated

Sep 12, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ronald Gussick, RPH

Title

President

Phone

(920) 533-4012

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• THE VILLAGE APOTHECARY Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mustafa Hafez, R.PH.

  • Pharmacist
  • Madison, WI
  • NPI 1427423318
  NPD (past)
• Brittany Schaefer, PHARMD

  • Pharmacist
  • Campbellsport, WI
  • NPI 1649821596
  NPD (past)

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189555200000",
    "number": "1053459040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W MAIN ST",
            "city": "CAMPBELLSPORT",
            "state": "WI",
            "postal_code": "530102704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W MAIN ST",
            "city": "CAMPBELLSPORT",
            "state": "WI",
            "postal_code": "530102704",
            "telephone_number": "920-533-4012",
            "fax_number": "920-533-4012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE APOTHECARY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2007-09-12",
        "status": "A",
        "authorized_official_last_name": "GUSSICK",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-533-4012",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "5998042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "5113636",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33008900",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "5113636",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE VILLAGE APOTHECARY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Deborah K Stocker, LPN
• Calyn Sue Strobel, RN
• Katherine Su, DDS
• Transtar Medical LTD.
• Dean William Uelmen, D.D.S.
• Village of Campbellsport (Campbellsport Vol Fire Dept)
• Lynn Wernicke, LPN
• Amanda Marie Wier, LPN
• Ashley M Zimdahl, RN

• Community/Retail Pharmacy in Campbellsport, WI
• Providers in Campbellsport, 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 Sep 12, 2007; 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.