H1 Lacrosse LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

8750042 Issued in WI

Legal business name

H1 LACROSSE LLC

Doing business as

Uvanta Pharmacy of LaCrosse

Practice address

2840 21St PL S
La Crosse, WI 54601-7302

Phone

(608) 784-6500

Fax

(608) 784-6504

NPI assigned

Jul 12, 2007

Last updated

Aug 9, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeff Vanstraten

Title

Owner

Phone

(262) 347-9405

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Uvanta Pharmacy of LaCrosse Doing business as

Locations

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312848000000",
    "number": "1417156209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2840 21ST PL S",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546017302",
            "telephone_number": "608-784-6500",
            "fax_number": "608-784-6504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2840 21ST PL S",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546017302",
            "telephone_number": "608-784-6500",
            "fax_number": "608-784-6504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "H1 LACROSSE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-12",
        "last_updated": "2011-08-09",
        "status": "A",
        "authorized_official_last_name": "VANSTRATEN",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-347-9405"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "WI",
            "license": "8750042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5130024",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33299800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Uvanta Pharmacy of LaCrosse",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Heather L Gustafson, RD
• Madeline Gutsch
• Hope Margaret Guzzo, M.D.
• Matthew H. Guzzo, M.D.
• Nicholas Samuel Guzzo, NP
• Evelyn Louis Haack
• Evi Grace Haak
• Matthew D Haberl, PT
• Sara A Habte, MD
• Linda Hackman

• Long Term Care Pharmacy in La Crosse, WI
• Providers in La Crosse, WI by specialty
• Long Term Care Pharmacy in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.

Verify at the official NPI Registry.