NPIMap

Gundersen Clinic LTD

Organization Active NPI Community/Retail Pharmacy · La Crosse, WI

NPI 1245705441 · NPPES record last updated Jul 4, 2025

Key facts

NPI
1245705441
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
Legal business name
GUNDERSEN CLINIC LTD
Practice address
2511 Green Bay St
La Crosse, WI 54601-5900
Phone
(608) 775-8585
NPI assigned
Oct 4, 2018
Organization subpart
Yes
Parent organization (as reported)
GUNDERSEN CLINIC LTD

Authorized official

Name
Tina Lechnir
Title
VP Cross-Functional Care
Phone
(608) 775-2600

Other NPIs on the same Medicare enrollment 5

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

Corporate family (same tax ID) 24

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

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Gundersen Clinic, LTD
2511 Green Bay St, La Crosse, WI 54601-5900 · (608) 775-8585		 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) Accepts assignment
Participating since Jan 1, 1998

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in WI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20170316002152 WI Part B Supplier - Mass Immunization (Roster Biller Only) 9638082779 5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Onalaska, WI; Tomah, WI; La Crosse, WI; Holmen, WI
O20190305001715 WI DME Supplier - Pharmacy 9638082779 Practice locations: La Crosse, WI

National Provider Directory

Tax ID family
La Liberte-Gundersen VI (52 organizations share this tax ID)
Part of
La Liberte-Gundersen VI

Locations

2511 Green Bay St
La Crosse, WI 54601
Phone (608) 775-8585

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Yes

Addresses

Primary practice location

2511 Green Bay St
La Crosse, WI 54601-5900

Mailing address

2511 Green Bay St
La Crosse, WI 54601-5900
Phone (608) 775-8585

Other names

  • Gundersen Pharmacy Doing business as
  • Gundersen Pharmacy - Village Shopping Center Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 4, 2025.

{
    "created_epoch": "1538611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751587200000",
    "number": "1245705441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2511 GREEN BAY ST",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015900",
            "telephone_number": "608-775-8585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 GREEN BAY ST",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015900",
            "telephone_number": "608-775-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUNDERSEN CLINIC LTD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GUNDERSEN CLINIC LTD",
        "enumeration_date": "2018-10-04",
        "last_updated": "2025-07-04",
        "certification_date": "2025-07-04",
        "status": "A",
        "authorized_official_last_name": "LECHNIR",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "VP CROSS-FUNCTIONAL CARE",
        "authorized_official_telephone_number": "608-775-2600"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gundersen Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gundersen Pharmacy - Village Shopping Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in La Crosse, WI

All providers in La Crosse, WI · Community/Retail Pharmacy in Wisconsin

Sources for this page

Verify at the official NPI Registry.