Carl Jeffrey Eliason

Primary specialty

PharmacistTaxonomy code 183500000X

License

10055040 Issued in WI

Legal business name

CARL JEFFREY ELIASON

Doing business as

Peoples Drug

Practice address

1124 Belknap St
Superior, WI 54880-2856

Phone

(715) 394-7765

Fax

(715) 394-7765

NPI assigned

Mar 13, 2007

Last updated

Sep 5, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Carl Jeff Eliason, PHARMACIST

Title

Owner Pharmacist

Phone

(715) 394-7765

Specialties & licenses 3

Addresses

Other names 1

• Peoples Drug Doing business as

Locations

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220572800000",
    "number": "1205969102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 BELKNAP ST",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548802856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 BELKNAP ST",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548802856",
            "telephone_number": "715-394-7765",
            "fax_number": "715-394-7765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARL JEFFREY ELIASON",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2008-09-05",
        "status": "A",
        "authorized_official_last_name": "ELIASON",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "JEFF",
        "authorized_official_title_or_position": "OWNER PHARMACIST",
        "authorized_official_telephone_number": "715-394-7765",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARMACIST"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "10055040",
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "WI",
            "license": "7047042",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peoples Drug",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pharmacist in Superior, WI
• Providers in Superior, WI by specialty
• Pharmacist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2008; 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.