Mequon Family Pharmacy Inc

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

MEQUON FAMILY PHARMACY INC

Practice address

1424 W Mequon Rd
Mequon, WI 53092-3226

Phone

(262) 581-0411

Fax

(262) 923-1002

NPI assigned

Feb 28, 2017

Last updated

Apr 11, 2017By 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

Laura Mugurdumova

Title

Ceo

Phone

(262) 581-0411

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 2

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.

• Dawn M Hamilton, PHARMD

  • Pharmacist
  • Mequon, WI
  • NPI 1023969649
  NPD (past)
• Jazmynn Worman

  • Pharmacist
  • Mequon, WI
  • NPI 1104455336
  NPD (past)

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

{
    "created_epoch": "1488240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491868800000",
    "number": "1538609292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1424 W MEQUON RD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530923226",
            "telephone_number": "262-581-0411",
            "fax_number": "262-923-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1424 W MEQUON RD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530923226",
            "telephone_number": "262-581-0411",
            "fax_number": "262-923-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEQUON FAMILY PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-28",
        "last_updated": "2017-04-11",
        "status": "A",
        "authorized_official_last_name": "MUGURDUMOVA",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "262-581-0411"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2168769",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mequon Clinical Associates, S.C.
• Mequon Clinical Associates, SC
• Mequon Dental Arts LLC
• Mequon Family Chiropractic LLC
• Mequon Family Eye Care, LLC
• Mequon Jewish Campus, Inc
• Mequon Labs Inc
• Mequon Labs Inc
• Mequon Plastic Surgeons SC
• Mequon Speech and Learning Connection (Milwaukee Myo)

• Pharmacy in Mequon, WI
• Providers in Mequon, WI by specialty
• Pharmacy in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; 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.