Organization Active NPI

St. Joseph's Community Hospital of West Bend, Inc.

Doing business as Froedtert Health St. Joseph's Hospital Pharmacy

  • Community/Retail Pharmacy
  • West Bend, WI
National Provider Identifier
1578842811
Registry record updated Mar 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
9081042 Issued in WI
Legal business name
ST. JOSEPH'S COMMUNITY HOSPITAL OF WEST BEND, INC.
Doing business as
Froedtert Health St. Joseph's Hospital Pharmacy
Practice address
3200 Pleasant Valley Rd Ste 1a
West Bend, WI 53095-9274
Phone
(414) 805-5113
NPI assigned
Aug 4, 2011
Last updated
Mar 9, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2015

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

Authorized official

Name
Binita PatelNPI 1013172345
Title
Assistant Director, Pharmacy
Phone
(414) 805-6512

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 9081042 WI Primary

Addresses

Primary practice location

3200 Pleasant Valley Rd Ste 1a
West Bend, WI 53095-9274

Mailing address

3200 Pleasant Valley Rd
Suite 1a
West Bend, WI 53095-9274
Phone (414) 805-5113

Other identifiers 1

IdentifierTypeStateIssuer
5132751OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • Froedtert Health St. Joseph's Hospital Pharmacy Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D0389008St Joseph's Community Hospital3200 Pleasant Valley Rd, West Bend, WI 53095AccreditationJan 2, 2027

National Provider Directory

National Provider Directory

Locations

3200 Pleasant Valley Rd
#A1
West Bend, WI 53095
Phone (262) 257-3073

3200 Pleasant Valley Rd
Ste 1A
West Bend, WI 53095
Phone (262) 836-5411

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": "1312416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425859200000",
    "number": "1578842811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 PLEASANT VALLEY RD",
            "address_2": "SUITE 1A",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530959274",
            "telephone_number": "414-805-5113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 PLEASANT VALLEY RD STE 1A",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530959274",
            "telephone_number": "414-805-5113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOSEPH'S COMMUNITY HOSPITAL OF WEST BEND, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-04",
        "last_updated": "2015-03-09",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "BINITA",
        "authorized_official_title_or_position": "ASSISTANT DIRECTOR, PHARMACY",
        "authorized_official_telephone_number": "414-805-6512"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "9081042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5132751",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Froedtert Health St. Joseph's Hospital Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Bend, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.