Active NPI
Morton Drug Co Inc
- Community/Retail Pharmacy
- Appleton, WI
National Provider Identifier
1215969217
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 8535
- Legal business name
- MORTON DRUG CO INC
- Practice address
- N162 Eisenhower Dr
Suite 100
Appleton, WI 54915-6171 - Phone
- (920) 731-4830
- Fax
- (920) 731-4709
- NPI assigned
- Jul 7, 2006
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 8535 | WI | Primary |
| Long Term Care Pharmacy | 3336L0003X |
Addresses
Primary practice location
N162 Eisenhower Dr
Suite 100
Appleton, WI 54915-6171
Mailing address
PO Box 778
Neenah, WI 54957-0778
Phone (920) 727-3853
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33286500 | Medicaid | WI | |
| 5104803 | Other | NCPDP PROVIDER IDENTIFICATION NUMBER |
Other names 1
- MORTON PHARMACY
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090528000558 | WI | Part B Supplier - Mass Immunization (Roster Biller Only) | 7113076860 |
12 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Neenah, WI |
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 DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1283904000000",
"number": "1215969217",
"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": "N162 EISENHOWER DR",
"address_2": "SUITE 100",
"city": "APPLETON",
"state": "WI",
"postal_code": "549156171",
"telephone_number": "920-731-4830",
"fax_number": "920-731-4709"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MORTON DRUG CO INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-07",
"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": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "WI",
"license": "8535",
"primary": true
},
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "33286500",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
"identifier": "5104803",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "MORTON PHARMACY",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Appleton, 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.