NPIMap

Organization Active NPI

PCCW LLC

Doing business as Welltopia Pharmacy

  • Long Term Care Pharmacy
  • Thiensville, WI
National Provider Identifier
1306427349
Registry record updated May 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
PCCW LLC
Doing business as
Welltopia Pharmacy
Practice address
136 N Main St Ste 102
Thiensville, WI 53092-1606
Phone
(262) 429-9429
Fax
(262) 429-9428
NPI assigned
Apr 20, 2021
Last updated
May 26, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2022

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

Authorized official

Name
Karina Chelsky
Title
Admin
Phone
(414) 467-8884

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

136 N Main St Ste 102
Thiensville, WI 53092-1606

Mailing address

136 N Main St Ste 102
Thiensville, WI 53092-1606
Phone (262) 429-9429

Other names 1

  • Welltopia Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
PCCW LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

  • PCCW LLC

    dba Welltopia Pharmacy

    • Community/Retail Pharmacy
    • Thiensville, WI
    • NPI 1346791753
    NPD tax ID

Locations

136 N Main St
Ste 102
Thiensville, WI 53092
Phone (262) 429-9429

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1618876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653523200000",
    "number": "1306427349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 N MAIN ST STE 102",
            "city": "THIENSVILLE",
            "state": "WI",
            "postal_code": "530921606",
            "telephone_number": "262-429-9429",
            "fax_number": "262-429-9428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 N MAIN ST STE 102",
            "city": "THIENSVILLE",
            "state": "WI",
            "postal_code": "530921606",
            "telephone_number": "262-429-9429",
            "fax_number": "262-429-9428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PCCW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-20",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A",
        "authorized_official_last_name": "CHELSKY",
        "authorized_official_first_name": "KARINA",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "414-467-8884"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Welltopia Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Welltopia Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Thiensville, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2022; 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.