Saint-Mark Enterprises 1798 LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

SAINT-MARK ENTERPRISES 1798 LLC

Doing business as

THE MEDICINE SHOPPE 1798

Practice address

300 Superior Avenue
Tomah, WI 54660

Phone

(608) 372-2101

NPI assigned

Jan 8, 2009

Organization subpart

No

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

Authorized official

Name

Mark Miller

Title

Officer / Managing Partner

Phone

(314) 518-2427

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• THE MEDICINE SHOPPE 1798 Doing business as

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

{
    "created_epoch": "1231372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706486400000",
    "number": "1619114931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 98",
            "city": "EUREKA",
            "state": "MO",
            "postal_code": "630250098",
            "telephone_number": "314-518-2427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SUPERIOR AVENUE",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "54660",
            "telephone_number": "608-372-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT-MARK ENTERPRISES 1798 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-08",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OFFICER / MANAGING PARTNER",
        "authorized_official_telephone_number": "314-518-2427"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "WI",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100002221",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP #",
            "identifier": "5131355",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE MEDICINE SHOPPE 1798",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anna Marie Rood, RN
• Abbey Alice Rose, CNM
• Kelly Donn Rudd, D.C.
• Rachel Rychlock, L.AC.
• Jennifer Sabally, MS, CCC-SLP
• Lisa Ann Salamon, MSN, RN, GCNS-BC
• Craig Norris Saltzgiver, M.D.
• Emile W. Salvo, M.D.
• Heather Sangl, CTRS
• Michael J Saunders, MD

• Community/Retail Pharmacy in Tomah, WI
• Providers in Tomah, WI by specialty
• Community/Retail Pharmacy in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; 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.