NPIMap

Organization Active NPI

The Pharmacy of New London Inc.

  • Community/Retail Pharmacy
  • New London, WI
National Provider Identifier
1295847119
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
THE PHARMACY OF NEW LONDON INC.
Practice address
1301 Mill St
New London, WI 54961-2153
Phone
(920) 982-7670
Fax
(920) 982-7686
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Jim Jernegan, RPH
Title
Owner Pharmacist
Phone
(920) 982-7670

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 6861 WI
Community/Retail Pharmacy 3336C0003X Primary
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

1301 Mill St
New London, WI 54961-2153

Mailing address

1301 Mill St
New London, WI 54961-2153
Phone (920) 982-7670

Other identifiers 2

IdentifierTypeStateIssuer
33152900MedicaidWI
5118698OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • Jernegan's Health Mart Pharmacy Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1295847119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 MILL ST",
            "city": "NEW LONDON",
            "state": "WI",
            "postal_code": "549612153",
            "telephone_number": "920-982-7670",
            "fax_number": "920-982-7686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 MILL ST",
            "city": "NEW LONDON",
            "state": "WI",
            "postal_code": "549612153",
            "telephone_number": "920-982-7670",
            "fax_number": "920-982-7686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PHARMACY OF NEW LONDON INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "JERNEGAN",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "OWNER PHARMACIST",
        "authorized_official_telephone_number": "920-982-7670",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "WI",
            "license": "6861",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "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": "33152900",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "5118698",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jernegan's Health Mart Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New London, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.