Active NPI
Warren W Samplaski, RPH
- Pharmacist
- West Bend, WI
National Provider Identifier
1346593266
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 10936-040
- Practice address
- 205 Valley Ave
West Bend, WI 53095-5312 - Phone
- (262) 338-2311
- NPI assigned
- Oct 16, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 10936-040 | WI | Primary |
Addresses
Primary practice location
205 Valley Ave
West Bend, WI 53095-5312
Mailing address
W2854 State Road 67
Iron Ridge, WI 53035-9616
Phone (920) 763-2694
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10936-040 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350345600000",
"number": "1346593266",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "W2854 STATE ROAD 67",
"city": "IRON RIDGE",
"state": "WI",
"postal_code": "530359616",
"telephone_number": "920-763-2694"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 VALLEY AVE",
"city": "WEST BEND",
"state": "WI",
"postal_code": "530955312",
"telephone_number": "262-338-2311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMPLASKI",
"first_name": "WARREN",
"middle_name": "W",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-10-16",
"last_updated": "2012-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "10936-040",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Bend, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.