NPIMap

Organization Active NPI

Degen Berglund Inc

Doing business as Degen Berglund Village

  • Community/Retail Pharmacy
  • La Crosse, WI
National Provider Identifier
1427086826
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
9090-042 Issued in WI
Legal business name
DEGEN BERGLUND INC
Doing business as
Degen Berglund Village
Practice address
2511 Green Bay Street
La Crosse, WI 54601-6155
Phone
(608) 775-8585
Fax
(608) 775-8598
NPI assigned
Jun 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Mr. Jon Bingol
Title
Director
Phone
(608) 775-8500

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X
Oxygen Equipment & Supplies (DME) 332BX2000X
Community/Retail Pharmacy 3336C0003X 9090-042 WI Primary

Addresses

Primary practice location

2511 Green Bay Street
La Crosse, WI 54601-6155

Mailing address

PO Box 3157
La Crosse, WI 54602-3157
Phone (608) 775-8500

Other identifiers 5

IdentifierTypeStateIssuer
0988816MedicaidIA
202224900MedicaidMN
5103851OtherWINCPDP
187315600MedicaidMN
33210900MedicaidWI

Other names 1

  • Degen Berglund Village Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1427086826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3157",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546023157",
            "telephone_number": "608-775-8500",
            "fax_number": "608-775-8555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 GREEN BAY STREET",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546016155",
            "telephone_number": "608-775-8585",
            "fax_number": "608-775-8598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEGEN BERGLUND INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-28",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "BINGOL",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "608-775-8500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "9090-042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0988816",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202224900",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "5103851",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "187315600",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33210900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Degen Berglund Village",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Degen Berglund Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Crosse, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.