Active NPI
Marguerite Mary Vavrosky, RPH
- Pharmacist
- Rice Lake, WI
National Provider Identifier
1376810358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 9479-40
- Practice address
- 502 S Main St
Rice Lake, WI 54868-2576 - Phone
- (715) 736-0120
- Fax
- (715) 736-0121
- NPI assigned
- Nov 19, 2011
- Last updated
- Nov 19, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 9479-40 | WI | Primary |
| Pharmacist | 183500000X | 5302025831 | MI |
Addresses
Primary practice location
502 S Main St
Rice Lake, WI 54868-2576
Mailing address
502 S Main St
Rice Lake, WI 54868-2576
Phone (715) 736-0120
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 |
|---|---|---|---|
| 5302025831 | MI | MD | Pharmacist |
| 9479-40 | WI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321660800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321660800000",
"number": "1376810358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "502 S MAIN ST",
"city": "RICE LAKE",
"state": "WI",
"postal_code": "548682576",
"telephone_number": "715-736-0120",
"fax_number": "715-736-0121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "502 S MAIN ST",
"city": "RICE LAKE",
"state": "WI",
"postal_code": "548682576",
"telephone_number": "715-736-0120",
"fax_number": "715-736-0121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAVROSKY",
"first_name": "MARGUERITE",
"middle_name": "MARY",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-11-19",
"last_updated": "2011-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "9479-40",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302025831",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rice Lake, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.