NPIMap

Organization Active NPI

Vernon Memorial Healthcare Inc

Doing business as Vernon Memorial Pharmacy Westby

  • Community/Retail Pharmacy
  • Westby, WI
National Provider Identifier
1447427505
Registry record updated Jan 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
8815-42 Issued in WI
Legal business name
VERNON MEMORIAL HEALTHCARE INC
Doing business as
Vernon Memorial Pharmacy Westby
Practice address
115 W State St
Westby, WI 54667-1254
Phone
(608) 634-2222
Fax
(608) 634-2427
NPI assigned
May 8, 2008
Last updated
Jan 7, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
VERNON MEMORIAL HEALTHCARE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 7, 2020

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

Authorized official

Name
David Hartberg
Title
Ceo
Phone
(608) 637-4796

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 8815-42 WI Primary

Addresses

Primary practice location

115 W State St
Westby, WI 54667-1254

Mailing address

115 W State St
Westby, WI 54667-1254
Phone (608) 634-2222

Other identifiers 2

IdentifierTypeStateIssuer
36225100MedicaidWI
2111118OtherPK

Other names 1

  • VERNON MEMORIAL PHARMACY WESTBY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Hirsch Clinic VMH6 organizations share this tax ID, including this one
Part of
Hirsch Clinic VMH

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

115 W State St
Westby, WI 54667
Phone (608) 634-2222

NPI Registry JSON

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

{
    "created_epoch": "1210204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578355200000",
    "number": "1447427505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 W STATE ST",
            "city": "WESTBY",
            "state": "WI",
            "postal_code": "546671254",
            "telephone_number": "608-634-2222",
            "fax_number": "608-634-2427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 W STATE ST",
            "city": "WESTBY",
            "state": "WI",
            "postal_code": "546671254",
            "telephone_number": "608-634-2222",
            "fax_number": "608-634-2427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERNON MEMORIAL HEALTHCARE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VERNON MEMORIAL HEALTHCARE, INC.",
        "enumeration_date": "2008-05-08",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A",
        "authorized_official_last_name": "HARTBERG",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "608-637-4796"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "8815-42",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36225100",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2111118",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VERNON MEMORIAL PHARMACY WESTBY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "VERNON MEMORIAL PHARMACY WESTBY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Westby, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2020; 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.