Beaver Dam Hometown Pharmacy LLC
Organization Active NPI Community/Retail Pharmacy · Beaver Dam, WI
NPI 1588036826 · NPPES record last updated Sep 8, 2025
Key facts
- NPI
- 1588036826
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- Legal business name
- BEAVER DAM HOMETOWN PHARMACY LLC
- Practice address
- 609 N Spring St
Beaver Dam, WI 53916-2040 - Phone
- (920) 356-1500
- Fax
- (920) 356-1510
- NPI assigned
- Oct 27, 2015
- Organization subpart
- No
Authorized official
- Name
- Daniel Strause
- Title
- Owner
- Phone
- (920) 992-6800
Practitioners 1
-
Abbigail Linde, RPH, PHARMD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 52D2124241 | Beaver Dam Hometown Pharmacy | Certificate of waiver | Jan 11, 2027 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Beaver Dam Hometown Pharmacy LLC |
Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Walkers|Orthoses: Off-The-Shelf|Ostomy Supplies|Urological Supplies|Enteral Nutrients|Nebulizer Equipment and/or Suppli… | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20151222000518 | WI | Part B Supplier - Mass Immunization (Roster Biller Only) | 6002117728 | Practice locations: Beaver Dam, WI |
| O20180203000088 | WI | DME Supplier - Pharmacy | 6002117728 | Practice locations: Beaver Dam, WI |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | 9411-42 | WI | |
| Community/Retail Pharmacy | 3336C0003X | Yes | ||
| Specialty Pharmacy | 3336S0011X |
Addresses
Primary practice location
609 N Spring St
Beaver Dam, WI 53916-2040
Mailing address
333 Lowville Rd
Rio, WI 53960-9437
Phone (920) 992-6800
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100309026 | Medicaid | WI |
Other names
- BEAVER DAM HOMETOWN PHARMACY
Other providers in Beaver Dam, WI
- Beaver Dam Dental LLC
- Beaver Dam Emergency Medicine S.C.
- Beaver Dam ENT LLC
- Beaver Dam Foot & Ankle Center, Inc.
- Beaver Dam Hearing Care, LLC
- Beaver Dam Unified School District
- Beaver Dam Women'S Health, LTD.
- Bedrock HCS at Beaver Dam LLC
- Gregory Beier
- Anne Bellotti
All providers in Beaver Dam, WI · Community/Retail Pharmacy in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 8, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.