Corcoran Healthcare ENT Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

7973-042 Issued in WI

Legal business name

CORCORAN HEALTHCARE ENT INC

Doing business as

Richland Family Prescription Center

Practice address

301 E 2ND St
Richland Center, WI 53581-1900

Phone

(608) 647-8806

Fax

(608) 647-2029

NPI assigned

Oct 26, 2016

Organization subpart

No

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

Authorized official

Name

Paul F Corcoran, RPH

Title

Owner

Phone

(608) 647-8806

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Richland Family Prescription Center Doing business as

Tax ID family

Corcoran Healthcare ENT Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Corcoran Healthcare Enterprises, Inc

  dba Reedsburg Family Prescription Center

  • Community/Retail Pharmacy
  • Reedsburg, WI
  • NPI 1174689616
  NPD tax ID

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

{
    "created_epoch": "1477440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478736000000",
    "number": "1164974036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E 2ND ST",
            "address_2": "PO BOX 309",
            "city": "RICHLAND CENTER",
            "state": "WI",
            "postal_code": "535811900",
            "telephone_number": "608-647-8806",
            "fax_number": "608-647-2029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E 2ND ST",
            "city": "RICHLAND CENTER",
            "state": "WI",
            "postal_code": "535811900",
            "telephone_number": "608-647-8806",
            "fax_number": "608-647-2029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORCORAN HEALTHCARE ENT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-26",
        "last_updated": "2016-11-10",
        "status": "A",
        "authorized_official_last_name": "CORCORAN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "608-647-8806",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "WI",
            "license": "7973-042",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "WI",
            "license": "7973-042",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CEDI TRADING PARTNER",
            "identifier": "B08230661",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33168200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Richland Family Prescription Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David E Chakoian, M.D.
• Andrea Kristin Cherry, PA-C
• Thomas James Chitwood, DDS
• Jessica Clark-Gomez
• Mary Jo Coleman
• Corcoran Healthcare Enterprises Inc (Richland Family Prescription Center)
• Paul F Corcoran Jr.
• County of Richland (Richland County Health and Human Services)
• County of Richland (Pine Valley Community Village)
• County of Richland (Richland County Health and Human Services)

• Pharmacy in Richland Center, WI
• Providers in Richland Center, WI by specialty
• Pharmacy in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2016; 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.