NPIMap

Organization Active NPI

State of Wisconsin

Doing business as Central Wisconsin Center Pharmacy Department

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Madison, WI
National Provider Identifier
1588703078
Registry record updated Oct 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
1000-042 Issued in WI
Legal business name
STATE OF WISCONSIN
Doing business as
Central Wisconsin Center Pharmacy Department
Practice address
317 Knutson Dr
Madison, WI 53704-1133
Phone
(608) 301-1946
Fax
(608) 301-1871
NPI assigned
Feb 5, 2007
Last updated
Oct 21, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
STATE OF WISCONSINAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 21, 2010

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

Authorized official

Name
Mrs. Janice Holling
Title
Center Director
Phone
(608) 301-9229

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 1000-042 WI Primary

Addresses

Primary practice location

317 Knutson Dr
Madison, WI 53704-1133

Mailing address

317 Knutson Dr
Madison, WI 53704-1133
Phone (608) 301-1946

Other identifiers 1

IdentifierTypeStateIssuer
5106770OtherWINCPDP

Other names 1

  • Central Wisconsin Center Pharmacy Department Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dept of Health Social8 organizations share this tax ID, including this one
Part of
Dept of Health Social

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287619200000",
    "number": "1588703078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 KNUTSON DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537041133",
            "telephone_number": "608-301-1946",
            "fax_number": "608-301-1871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 KNUTSON DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537041133",
            "telephone_number": "608-301-1946",
            "fax_number": "608-301-1871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF WISCONSIN",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE OF WISCONSIN",
        "enumeration_date": "2007-02-05",
        "last_updated": "2010-10-21",
        "status": "A",
        "authorized_official_last_name": "HOLLING",
        "authorized_official_first_name": "JANICE",
        "authorized_official_title_or_position": "CENTER DIRECTOR",
        "authorized_official_telephone_number": "608-301-9229",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "WI",
            "license": "1000-042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "5106770",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Wisconsin Center Pharmacy Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.