Badger Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

8993-042 Issued in WI

Legal business name

BADGER PHARMACY LLC

Practice address

2106 Grand Ave
Wausau, WI 54403-6912

Phone

(715) 845-3713

Fax

(715) 845-7957

NPI assigned

Dec 29, 2009

Organization subpart

No

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

Authorized official

Name

Forrest Young

Title

Owner

Phone

(715) 842-0370

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Young's Drug Store Doing business as

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

{
    "created_epoch": "1262044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407196800000",
    "number": "1124358940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 S 72ND AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544019038",
            "telephone_number": "715-842-0370",
            "fax_number": "715-842-0366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 GRAND AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544036912",
            "telephone_number": "715-845-3713",
            "fax_number": "715-845-7957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BADGER PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-29",
        "last_updated": "2014-08-05",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "FORREST",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-842-0370"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "8993-042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124358940",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "5132131",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Young's Drug Store",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joseph W Babiarz, M.D.
• Miranda Tina Martha Babl, LPC
• Debra Jean Backes, R.D.H.
• Tonia Yvette Backman, LCSW
• Badger Pharmacy LLC
• Badger Pharmacy LLC
• Katelin Bagley
• Baker Borski Chiropractic SC
• Christine Baker, OTD/OTR
• Robin L Baker, D.C.

• All providers in Wausau, WI
• Community/Retail Pharmacy in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.