Marshland Pharmacies Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

8546042 Issued in WI

Legal business name

MARSHLAND PHARMACIES INC

Practice address

705 S University Ave
Beaver Dam, WI 53916-3053

Phone

(920) 356-0040

Fax

(920) 356-0056

NPI assigned

Jul 30, 2006

Organization subpart

No

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

Authorized official

Name

John Sutter

Title

Co Owner/Pharm MGR

Phone

(920) 356-0040

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• MARSHLAND PHARMACY Doing business as

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410739200000",
    "number": "1124033758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 S UNIVERSITY AVE",
            "address_2": "SUITE 180",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539163053",
            "telephone_number": "920-356-0040",
            "fax_number": "920-356-0056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 S UNIVERSITY AVE",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539163053",
            "telephone_number": "920-356-0040",
            "fax_number": "920-356-0056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARSHLAND PHARMACIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2014-09-15",
        "status": "A",
        "authorized_official_last_name": "SUTTER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CO OWNER/PHARM MGR",
        "authorized_official_telephone_number": "920-356-0040"
    },
    "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": "8546042",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2110854",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33287900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MARSHLAND PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Madison Vamc
• Nidhi Mahajan, DMD
• Riley Jean Malliet
• Daniel G Malone, MD
• Ami Mantych, APNP
• Tyler John Marx, LPC-IT
• Daniel Joseph Massie, LCSW, CSAC, CS-IT
• Tia Mathwich, PT
• Timothy Mathwich, DPT
• Stefanie Marie McKnight

• Community/Retail Pharmacy in Beaver Dam, WI
• Providers in Beaver Dam, 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 15, 2014; 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.