NPIMap

Organization Active NPI

Morton Drug Co Inc

Doing business as Morton Pharmacy

  • Community/Retail Pharmacy
  • Neenah, WI
National Provider Identifier
1184713869
Registry record updated Sep 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
8304 Issued in WI
Legal business name
MORTON DRUG CO INC
Doing business as
Morton Pharmacy
Practice address
1554 S Commercial St
Neenah, WI 54956-4802
Phone
(920) 727-3840
Fax
(920) 886-8995
NPI assigned
Oct 12, 2006
Last updated
Sep 8, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2010

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

Authorized official

Name
Jeffrey Blank
Title
VP Corporate Services
Phone
(920) 727-8882

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 8304 WI Primary
Long Term Care Pharmacy 3336L0003X NU

Addresses

Primary practice location

1554 S Commercial St
Neenah, WI 54956-4802

Mailing address

PO Box 778
Neenah, WI 54957-0778
Phone (920) 727-3853

Other identifiers 2

IdentifierTypeStateIssuer
33188500MedicaidWI
5108356OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • MORTON PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090528000558 WI Part B Supplier - Mass Immunization (Roster Biller Only) 7113076860 12 other NPIs on this enrollment
Practice locations: Neenah, WI

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283904000000",
    "number": "1184713869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 778",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549570778",
            "telephone_number": "920-727-3853",
            "fax_number": "920-727-3867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1554 S COMMERCIAL ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549564802",
            "telephone_number": "920-727-3840",
            "fax_number": "920-886-8995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORTON DRUG CO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2010-09-08",
        "status": "A",
        "authorized_official_last_name": "BLANK",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "VP CORPORATE SERVICES",
        "authorized_official_telephone_number": "920-727-8882"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "8304",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33188500",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5108356",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MORTON PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Neenah, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.