NPIMap

Organization Active NPI

Morton Drug Co Inc

Doing business as Morton LTC Appleton

  • Long Term Care Pharmacy
  • Appleton, WI
National Provider Identifier
1457440133
Registry record updated Jan 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
6893042 Issued in WI
Legal business name
MORTON DRUG CO INC
Doing business as
Morton LTC Appleton
Practice address
601 W College Ave
Appleton, WI 54911-5803
Phone
(920) 738-5823
Fax
(920) 882-3323
NPI assigned
Oct 12, 2006
Last updated
Jan 18, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2012

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

Authorized official

Name
Jeffrey Blank
Title
VP Corporate Services
Phone
(920) 727-8882

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X 6893042 WI Primary

Addresses

Primary practice location

601 W College Ave
Appleton, WI 54911-5803

Mailing address

PO Box 778
Neenah, WI 54957-0778
Phone (920) 727-3853

Other identifiers 2

IdentifierTypeStateIssuer
33098900MedicaidWI
5100994OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • MORTON LTC APPLETON Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090528000558 WI Part B Supplier - Mass Immunization (Roster Biller Only) 7113076860 12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Neenah, WI

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

601 W College Ave
Appleton, WI 54911
Phone (920) 738-5822

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326844800000",
    "number": "1457440133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 778",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549570778",
            "telephone_number": "920-727-3853",
            "fax_number": "920-727-3867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W COLLEGE AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549115803",
            "telephone_number": "920-738-5823",
            "fax_number": "920-882-3323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORTON DRUG CO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2012-01-18",
        "status": "A",
        "authorized_official_last_name": "BLANK",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "VP CORPORATE SERVICES",
        "authorized_official_telephone_number": "920-727-8882"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "WI",
            "license": "6893042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33098900",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5100994",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MORTON LTC APPLETON",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.