Fall Creek Pharmacy, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

8903042 Issued in WI

Legal business name

FALL CREEK PHARMACY, INC.

Doing business as

Fall Creek Pharmacy

Practice address

119 E Lincoln Ave
Fall Creek, WI 54742-9526

Phone

(715) 877-2994

Fax

(715) 877-3248

NPI assigned

Dec 20, 2006

Organization subpart

No

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

Authorized official

Name

Miss Rebecca J Stoner, RPH

Title

RPH /Store Manager

Phone

(715) 877-2994

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• FALL CREEK PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281052800000",
    "number": "1144384629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 E LINCOLN AVE",
            "address_2": "PO BOX 217",
            "city": "FALL CREEK",
            "state": "WI",
            "postal_code": "547429526",
            "telephone_number": "715-877-2994",
            "fax_number": "715-877-3248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 E LINCOLN AVE",
            "city": "FALL CREEK",
            "state": "WI",
            "postal_code": "547429526",
            "telephone_number": "715-877-2994",
            "fax_number": "715-877-3248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FALL CREEK PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2010-08-06",
        "status": "A",
        "authorized_official_last_name": "STONER",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "RPH /STORE MANAGER",
        "authorized_official_telephone_number": "715-877-2994",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "8903042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144384629",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FALL CREEK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Virginia Carol Duerst, PHD
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• Fall Creek Dental
• Fall Creek Family Dental, LLC
• Fall Creek School District
• Lorri Lynn Hellegers, R.D.H.
• Peter Mandelert Ihle, M.D.
• Nicole McEvoy
• Beth McVey, D.C.

• Community/Retail Pharmacy in Fall Creek, WI
• Providers in Fall Creek, 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 Aug 6, 2010; 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.