NPIMap

Organization Active NPI

Mount Horeb Family Pharmacy LLC

  • Clinic Pharmacy
  • Mount Horeb, WI
National Provider Identifier
1235924291
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
Legal business name
MOUNT HOREB FAMILY PHARMACY LLC
Practice address
203 W Main St
Mount Horeb, WI 53572-1914
Phone
(608) 437-3001
Fax
(608) 437-6480
NPI assigned
Apr 10, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Authorized official

Name
Jennifer Weiland
Title
Business Manager/Owner
Phone
(608) 437-3001

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X
Primary Care Clinic/Center 261QP2300X
Clinic Pharmacy 3336C0002X Primary

Addresses

Primary practice location

203 W Main St
Mount Horeb, WI 53572-1914

Mailing address

203 W Main St
Mount Horeb, WI 53572-1914
Phone (608) 437-3001

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220504000047 WI Part B Supplier - Pharmacy 6709273162 1 other NPI on this enrollment
Practice locations: Mount Horeb, 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 1

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

National Provider Directory

National Provider Directory
Tax ID family
Mount Horeb Family Pharm3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1744243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757980800000",
    "number": "1235924291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 W MAIN ST",
            "city": "MOUNT HOREB",
            "state": "WI",
            "postal_code": "535721914",
            "telephone_number": "608-437-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 W MAIN ST",
            "city": "MOUNT HOREB",
            "state": "WI",
            "postal_code": "535721914",
            "telephone_number": "608-437-3001",
            "fax_number": "608-437-6480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNT HOREB FAMILY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-10",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A",
        "authorized_official_last_name": "WEILAND",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "BUSINESS MANAGER/OWNER",
        "authorized_official_telephone_number": "608-437-3001"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Horeb, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2025; 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.