Gretchen Lynn Konrardy, PHARMD
Individual provider Active NPI Pharmacist · Lancaster, WI
NPI 1578692000 · NPPES record last updated May 29, 2020
Key facts
- NPI
- 1578692000
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 19813 (IA)
- Practice address
- 139 W Maple St
Lancaster, WI 53813-1640 - Phone
- (608) 723-4737
- Fax
- (608) 723-4735
- NPI assigned
- Mar 2, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051.295474 | IL | MD | Pharmacist |
| 16623-40 | WI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hartig Drug Co Corp | Past |
Accepting new patients | |
| Hartig Drug Co Corp | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051.295474 | IL | |
| Pharmacist | 183500000X | 16623-40 | WI | |
| Pharmacist | 183500000X | 19813 | IA | Yes |
Addresses
Primary practice location
139 W Maple St
Lancaster, WI 53813-1640
Mailing address
139 W Maple St
Lancaster, WI 53813-1640
Phone (608) 723-4737
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0014530 | Medicaid | IA |
Other providers in Lancaster, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 29, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.