Waupaca Woods Pharmacy Inc.

Primary specialty

Clinic PharmacyTaxonomy code 3336C0002X

License

7739 Issued in WI

Legal business name

WAUPACA WOODS PHARMACY INC.

Doing business as

Riverside Clinic Pharmacy

Practice address

800 Riverside Dr
Waupaca, WI 54981-1943

Phone

(715) 256-1115

Fax

(715) 256-1105

NPI assigned

Nov 7, 2006

Last updated

Jun 17, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeffrey Leo Oestreich, RPH

Title

President

Phone

(715) 256-1115

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Riverside Clinic Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1639248172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 N WESTERN AVE",
            "city": "WAUPACA",
            "state": "WI",
            "postal_code": "549812201",
            "telephone_number": "715-258-7621",
            "fax_number": "715-258-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 RIVERSIDE DR",
            "city": "WAUPACA",
            "state": "WI",
            "postal_code": "549811943",
            "telephone_number": "715-256-1115",
            "fax_number": "715-256-1105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAUPACA WOODS PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "OESTREICH",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "LEO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "715-256-1115",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "WI",
            "license": "7739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33228100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverside Clinic Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinic Pharmacy in Waupaca, WI
• Providers in Waupaca, WI by specialty
• Clinic Pharmacy in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; 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.