Park Pharmacy Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

7644-042 Issued in WI

Legal business name

PARK PHARMACY INC

Practice address

138 2ND Ave N
Park Falls, WI 54552-1214

Phone

(715) 762-3248

Fax

(715) 762-2980

NPI assigned

May 31, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Mark Pechacek

Title

Owner

Phone

(715) 762-3248

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Park Pharmacy Inc

  dba North Central IV

  • Long Term Care Pharmacy
  • Park Falls, WI
  • NPI 1316940679
  NPPES parent name

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505174400000",
    "number": "1689677999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 2ND AVE N",
            "city": "PARK FALLS",
            "state": "WI",
            "postal_code": "545521214",
            "telephone_number": "715-762-3248",
            "fax_number": "715-762-2980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 2ND AVE N",
            "city": "PARK FALLS",
            "state": "WI",
            "postal_code": "545521214",
            "telephone_number": "715-762-3248",
            "fax_number": "715-762-2980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-31",
        "last_updated": "2017-09-12",
        "status": "A",
        "authorized_official_last_name": "PECHACEK",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-762-3248",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "WI",
            "license": "7644-042",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "WI",
            "license": "7643-042",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33219200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Park Falls Regional Medical Clinic, S.C.
• Park Manor LTD
• Park Manor, LTD.
• Park Manor, LTD.
• Park Pharmacy Inc (North Central IV)
• Amy Pearson, MA, PT, CWS
• Mark Steven Pechacek, RPH
• Tennille H. Penn, D.D.S.
• Eric M Peters, DMD
• Thomas B. Prebble, MD

• Pharmacy in Park Falls, WI
• Providers in Park Falls, WI by specialty
• Pharmacy in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.