Sparta Pharmacy LLC.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

8783042 Issued in WI

Legal business name

SPARTA PHARMACY LLC.

Doing business as

Sparta Pharmacy

Practice address

201 S Water St
Sparta, WI 54656-1724

Phone

(608) 269-2949

Fax

(608) 269-3330

NPI assigned

Feb 27, 2007

Last updated

Dec 2, 2014By 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

Tom Brieske

Title

Manager

Phone

(608) 386-9039

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• SPARTA PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in WI2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 6

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.

• Hannah Lorraine Butler

  • Pharmacist
  • West Salem, WI
  • NPI 1619850435
  NPD (past)
• Douglas A Hansen, PHARM. D.

  • Pharmacist
  • Sparta, WI
  • NPI 1518198902
  NPD (past)
• Matthew James Hansen, PHARMD.

  • Pharmacist
  • Sparta, WI
  • NPI 1992672604
  NPD (past)
• Gary J Korthals, RPH

  • Pharmacist
  • Sparta, WI
  • NPI 1316276660
  NPD (past)
• Haley Rose Kroener, PHARMD, RPH

  • Pharmacist
  • West Salem, WI
  • NPI 1689559544
  NPD (past)
• Marcy Beth Lattos, RPH

  • Pharmacist
  • West Salem, WI
  • NPI 1609116094
  NPD (past)

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417478400000",
    "number": "1528194933",
    "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": "608-269-2949",
            "fax_number": "608-269-3330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S WATER ST",
            "city": "SPARTA",
            "state": "WI",
            "postal_code": "546561724",
            "telephone_number": "608-269-2949",
            "fax_number": "608-269-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARTA PHARMACY LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2014-12-02",
        "status": "A",
        "authorized_official_last_name": "BRIESKE",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "608-386-9039"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "8783042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2111020",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33296600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SPARTA PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sparta Area Ambulance Service LTD
• Sparta Area School District
• Sparta Chiropractic Clinic, LLC
• Sparta Dental Center SC
• Sparta Family Dentistry, LLC
• St. Clare Health Mission of Monroe County, Inc
• Jill M Stebbins, MD
• Megan J Steele, O.T.
• Tracy Rae Steele
• Jessica Robin Stefanski-Williams, DO

• Community/Retail Pharmacy in Sparta, WI
• Providers in Sparta, WI by specialty
• Community/Retail Pharmacy in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.