NPIMap

Organization Active NPI

B7 Pharmacy Inc

Doing business as Good Value Pharmacy Racine

  • Community/Retail Pharmacy
  • Racine, WI
National Provider Identifier
1174021778
Registry record updated Jan 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
9494-42 Issued in WI
Legal business name
B7 PHARMACY INC
Doing business as
Good Value Pharmacy Racine
Practice address
5220 Washington Ave # 101
Racine, WI 53406-4228
Phone
(262) 632-6561
Fax
(262) 632-6505
NPI assigned
Jan 29, 2018
Last updated
Jan 29, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
B7 PHARMACY INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 29, 2018

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

Authorized official

Name
Alex Berce, PHARMDNPI 1306287354
Title
President
Phone
(262) 658-8124

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 9494-42 WI Primary

Addresses

Primary practice location

5220 Washington Ave # 101
Racine, WI 53406-4228

Mailing address

3825 39TH Ave
Ste 100
Kenosha, WI 53144
Phone (262) 658-8124

Other names 1

  • Good Value Pharmacy Racine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20180423002226 WI Part B Supplier - Mass Immunization (Roster Biller Only) 5799853156 Practice locations: Racine, WI
O20190827000978 WI DME Supplier - Pharmacy 5799853156 Practice locations: Racine, WI

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D2162833Good Value Pharmacy Racine5220 Washington Ave, Suite #101, Racine, WI 53406Certificate of waiverFeb 28, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
B7 Pharmacy Inc5220 Washington Ave, Racine, WI 53406-2440(262) 632-6561 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Oct 1, 2008

National Provider Directory

National Provider Directory
Tax ID family
B7 Pharmacy Inc5 organizations share this tax ID, including this one
Part of
B7 Pharmacy Inc

Other organizations with this tax ID 4

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

Locations

3207 80th St
#100
Kenosha, WI 53142
Phone (262) 697-5744

3401 80th St
Ste 100
Kenosha, WI 53142
Phone (262) 697-5744

3825 39th Ave
Ste 100
Kenosha, WI 53144
Phone (262) 658-8124

9916 75th St
Ste 103
Kenosha, WI 53142
Phone (262) 925-0201

5220 Washington Ave
Ste 101
Racine, WI 53406
Phone (262) 632-6500

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1517184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517184000000",
    "number": "1174021778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3825 39TH AVE",
            "address_2": "STE 100",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "53144",
            "telephone_number": "262-658-8124",
            "fax_number": "262-564-8667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5220 WASHINGTON AVE # 101",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534064228",
            "telephone_number": "262-632-6561",
            "fax_number": "262-632-6505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "B7 PHARMACY INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "B7 PHARMACY INC",
        "enumeration_date": "2018-01-29",
        "last_updated": "2018-01-29",
        "status": "A",
        "authorized_official_last_name": "BERCE",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-658-8124",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "9494-42",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Good Value Pharmacy Racine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Racine, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.