Wodele Enterprises Incorporated

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

2621160 Issued in MN

Legal business name

WODELE ENTERPRISES INCORPORATED

Doing business as

Wabasha Pharmacy

Practice address

207 Main St W
Wabasha, MN 55981-1238

Phone

(651) 565-3949

Fax

(651) 565-0030

NPI assigned

Feb 15, 2007

Last updated

Aug 22, 2020By 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. Timothy Wodele, RPH

Title

Owner

Phone

(651) 565-3949

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Wabasha Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265575302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 MAIN ST W",
            "city": "WABASHA",
            "state": "MN",
            "postal_code": "559811238",
            "telephone_number": "651-565-3949",
            "fax_number": "651-565-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 MAIN ST W",
            "city": "WABASHA",
            "state": "MN",
            "postal_code": "559811238",
            "telephone_number": "651-565-3949",
            "fax_number": "651-565-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WODELE ENTERPRISES INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WODELE",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-565-3949",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MN",
            "license": "2621160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33258400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wabasha Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Matthew Wagner, NP
• Nicole Marie Wallis, MD
• Julie L Walsh
• Wenden Recovery Services of Wabasha
• Malinda Jean Wise, MSW, LICSW

• Community/Retail Pharmacy in Wabasha, MN
• Providers in Wabasha, MN by specialty
• Community/Retail Pharmacy in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.