Pharmacy Compounding Center Associates LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

943642 Issued in WI

Legal business name

PHARMACY COMPOUNDING CENTER ASSOCIATES LLC

Practice address

1907 West Ave S
La Crosse, WI 54601-6206

Phone

(608) 788-4500

Fax

(608) 788-4501

NPI assigned

Dec 6, 2016

Organization subpart

No

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

Authorized official

Name

Thomas Brieske

Title

Owner

Phone

(608) 386-9039

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1480982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480982400000",
    "number": "1497299762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 185",
            "city": "WEST SALEM",
            "state": "WI",
            "postal_code": "546690185",
            "telephone_number": "608-386-9039",
            "fax_number": "608-788-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 WEST AVE S",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546016206",
            "telephone_number": "608-788-4500",
            "fax_number": "608-788-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMACY COMPOUNDING CENTER ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-06",
        "last_updated": "2016-12-06",
        "status": "A",
        "authorized_official_last_name": "BRIESKE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "608-386-9039"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "943642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WISCONSIN PHARMACY LIC",
            "identifier": "943642",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Pfaff, LPC
• Stephanie Ann Pfaff
• Joshua David Pfeiffer, M.D.
• Ben Pfiffner, MS
• Thanh Pham, M.D.
• Chantell Phillips, LPC, CSAC
• Todd C Phillips, MD
• Austin James Phippen, DO
• Sophia Dawn Picchiotti
• Amanda Noel Pickar, APNP

• All providers in La Crosse, WI
• Community/Retail Pharmacy in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2016; 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.