Northbay Pharmacy, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

6710-042 Issued in WI

Legal business name

NORTHBAY PHARMACY, INC

Practice address

686 N 4TH St
P.O. 228
Tomahawk, WI 54487-2123

Phone

(715) 453-5996

Fax

(715) 453-4508

NPI assigned

Sep 14, 2006

Last updated

Jul 2, 2012By 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

William Ray Dreger, R.PH.

Title

Pharmacist

Phone

(715) 453-5996

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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.

• Michelle M Smith, RPH

  • Pharmacist
  • Tomahawk, WI
  • NPI 1528405628
  NPD (past)
• Michelle Marie Venzke, RPH

  • Pharmacist
  • Tomahawk, WI
  • NPI 1376887380
  NPD (past)

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341187200000",
    "number": "1245335835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "686 N 4TH ST",
            "address_2": "P.O. 228",
            "city": "TOMAHAWK",
            "state": "WI",
            "postal_code": "544872123",
            "telephone_number": "715-453-5996",
            "fax_number": "715-453-4508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "686 N 4TH ST",
            "address_2": "P.O. 228",
            "city": "TOMAHAWK",
            "state": "WI",
            "postal_code": "544872123",
            "telephone_number": "715-453-5996",
            "fax_number": "715-453-4508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHBAY PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2012-07-02",
        "status": "A",
        "authorized_official_last_name": "DREGER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "715-453-5996",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "6710-042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33033200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Minocqua Optical & Wellness LLC (DBA Tomahawk Eyecare)
• Zoie L Mohr, DC
• Lori L. Mott, M.P.T.
• Kerry Newbury, PMHNP
• Emily Nicklaus, MS CCC-SLP
• Northern Chiropractic
• Northern Sight Vision Clinic, LLC
• Northwoods Counseling LLC
• NSH Golden Age LLC (Tomahawk Health Services)
• NSH Riverview LLC (Riverview Health Services)

• Community/Retail Pharmacy in Tomahawk, WI
• Providers in Tomahawk, WI by specialty
• Community/Retail Pharmacy in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2012; 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.