NPIMap

Organization Active NPI

Pharmacare LTD

Doing business as Eds Pharmacy

  • Community/Retail Pharmacy
  • Bloomer, WI
National Provider Identifier
1184726077
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
PHARMACARE LTD
Doing business as
Eds Pharmacy
Practice address
1511 Main St
Bloomer, WI 54724-1640
Phone
(715) 568-2190
Fax
(715) 568-2196
NPI assigned
Sep 2, 2006
Last updated
Nov 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

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

Authorized official

Name
Brandin J Henke
Title
Owner
Phone
(715) 833-6770

Specialties & licenses 3

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

Addresses

Primary practice location

1511 Main St
Bloomer, WI 54724-1640

Mailing address

1511 Main St
Bloomer, WI 54724-1640
Phone (715) 568-2190

Other identifiers 1

IdentifierTypeStateIssuer
33296700MedicaidWI

Other names 1

  • Eds Pharmacy Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930003885 WI DME Supplier - Pharmacy 4082829601 Practice locations: Bloomer, WI
O20120202000575 WI Part B Supplier - Mass Immunization (Roster Biller Only) 4082829601 10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Whitehall, WI; Bloomer, WI; Mondovi, WI; Barron, WI; Chetek, WI; Augusta, WI

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 8

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

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
52D2269303Eds Pharmacy1511 Main St, Bloomer, WI 54724Certificate of waiverSep 22, 2026

National Provider Directory

National Provider Directory
Tax ID family
Pharmacare LTD10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

NPI Registry JSON

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637539200000",
    "number": "1184726077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 MAIN ST",
            "city": "BLOOMER",
            "state": "WI",
            "postal_code": "547241640",
            "telephone_number": "715-568-2190",
            "fax_number": "715-568-2196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 MAIN ST",
            "city": "BLOOMER",
            "state": "WI",
            "postal_code": "547241640",
            "telephone_number": "715-568-2190",
            "fax_number": "715-568-2196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMACARE LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-02",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A",
        "authorized_official_last_name": "HENKE",
        "authorized_official_first_name": "BRANDIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-833-6770"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "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": "33296700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eds Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bloomer, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; 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.