Organization Active NPI

Vaxpro LLC

  • Clinic/Center
  • Verona, WI
National Provider Identifier
1619052172
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
VAXPRO LLC
Practice address
230 Horizon Dr Ste 101B
Verona, WI 53593-1256
Phone
(262) 241-4522
Fax
(262) 241-0626
NPI assigned
Oct 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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

Authorized official

Name
Dr. Mina Said, PHARMDNPI 1720560576
Title
Ceo
Phone
(262) 241-4522

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 10629-040 WI
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

230 Horizon Dr Ste 101B
Verona, WI 53593-1256

Mailing address

230 Horizon Dr Ste 101B
Verona, WI 53593-1256
Phone (262) 241-4522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060418000540 WI Part B Supplier - Mass Immunization (Roster Biller Only) 7315956489 Practice locations: Mequon, WI

National Provider Directory

National Provider Directory

Locations

5550 Carmel Mountain Rd
Ste 111A
San Diego, CA 92130

200 E Pratt St
Baltimore, MD 21202

875 N High St
#300
Columbus, OH 43215

11516 N Port Washington Rd
Ste 102
Mequon, WI 53092
Phone (262) 241-4522

10144 N Port Washington Rd
Mequon, WI 53092

10144 N Port Washington Rd
Ste Lle
Mequon, WI 53092
Phone (414) 403-8677

1001 W Glen Oaks Ln
Mequon, WI 53092

631 E Chicago St
Milwaukee, WI 53202
Phone (414) 223-2180

9363 N 76th St
Milwaukee, WI 53223
Phone (414) 355-1120

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740960000000",
    "number": "1619052172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 HORIZON DR STE 101B",
            "city": "VERONA",
            "state": "WI",
            "postal_code": "535931256",
            "telephone_number": "262-241-4522",
            "fax_number": "262-241-0626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 HORIZON DR STE 101B",
            "city": "VERONA",
            "state": "WI",
            "postal_code": "535931256",
            "telephone_number": "262-241-4522",
            "fax_number": "262-241-0626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAXPRO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A",
        "authorized_official_last_name": "SAID",
        "authorized_official_first_name": "MINA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "262-241-4522",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "10629-040",
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Verona, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2025; 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.