Mayo Clinic Health System - Pharmacy & Home Medical Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

6005 Issued in WI

Legal business name

MAYO CLINIC HEALTH SYSTEM - PHARMACY & HOME MEDICAL INC

Doing business as

Mayo Clinic Store - Midelfort

Practice address

1400 Bellinger St.
Suite PHM #3
Eau Claire, WI 54703-5222

Phone

(715) 838-1815

NPI assigned

Jul 31, 2006

Organization subpart

Yes

Parent organization

MAYO CLINIC HEALTH SYSTEM - PHARMACY & HOME MEDICAL, INC.As reported in NPPES

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

Authorized official

Name

Julie S Hansen

Title

Cfo

Phone

(715) 838-5270

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mayo Clinic Store - Midelfort Doing business as

Part of

Mayo Clinic Health System - Pharmacy Home Medical Inc

Locations

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545091200000",
    "number": "1326054727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 1ST ST SW STE 1-18",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559023124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 BELLINGER ST.",
            "address_2": "SUITE PHM #3",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547035222",
            "telephone_number": "715-838-1815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYO CLINIC HEALTH SYSTEM - PHARMACY & HOME MEDICAL INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MAYO CLINIC HEALTH SYSTEM - PHARMACY & HOME MEDICAL, INC.",
        "enumeration_date": "2006-07-31",
        "last_updated": "2018-12-18",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "715-838-5270"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "WI",
            "license": "6005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33094500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mayo Clinic Store - Midelfort",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melissa Maxwell
• Elise Meredith May, RPH
• Jonathan Mayer, BA
• Leland Robert Mayer, MD
• Charles Andre Mayeux, DO
• Mayo Clinic Health System - Pharmacy & Home Medical, Inc
• Mayo Clinic Health System - Pharmacy & Home Medical, Inc
• Mayo Clinic Health System - Pharmacy & Home Medical, Inc
• Mayo Clinic Health System - Pharmacy & Home Medical, Inc.
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

• Durable Medical Equipment & Medical Supplies in Eau Claire, WI
• Providers in Eau Claire, WI by specialty
• Durable Medical Equipment & Medical Supplies in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2018; 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.