NPIMap

Organization Active NPI

Gwidt Pharmacy Inc

Doing business as Gwidt Pharmacy

  • Long Term Care Pharmacy
  • Wittenberg, WI
National Provider Identifier
1649501586
Registry record updated Aug 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
8989-42 Issued in WI
Legal business name
GWIDT PHARMACY INC
Doing business as
Gwidt Pharmacy
Practice address
203 E Westgor Ave
Suite 1
Wittenberg, WI 54499-9174
Phone
(715) 253-2164
Fax
(715) 253-3030
NPI assigned
Jan 15, 2010
Last updated
Aug 12, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2016

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

Authorized official

Name
Shane ReschNPI 1578966933
Title
Vice-President
Phone
(715) 253-2164

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Long Term Care Pharmacy 3336L0003X 8989-42 WI Primary

Addresses

Primary practice location

203 E Westgor Ave
Suite 1
Wittenberg, WI 54499-9174

Mailing address

PO Box 253
Wittenberg, WI 54499-0253
Phone (715) 253-2164

Other identifiers 1

IdentifierTypeStateIssuer
2123642OtherPK

Other names 1

  • Gwidt Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Gwidt Pharmacy Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

203 E Westgor Ave
Ste 1
Wittenberg, WI 54499
Phone (715) 253-2164

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1263513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470960000000",
    "number": "1649501586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 253",
            "city": "WITTENBERG",
            "state": "WI",
            "postal_code": "544990253",
            "telephone_number": "715-253-2164",
            "fax_number": "715-253-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 E WESTGOR AVE",
            "address_2": "SUITE 1",
            "city": "WITTENBERG",
            "state": "WI",
            "postal_code": "544999174",
            "telephone_number": "715-253-2164",
            "fax_number": "715-253-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GWIDT PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-15",
        "last_updated": "2016-08-12",
        "status": "A",
        "authorized_official_last_name": "RESCH",
        "authorized_official_first_name": "SHANE",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "715-253-2164"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "WI",
            "license": "8989-42",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2123642",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gwidt Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wittenberg, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2016; 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.