NPIMap

Organization Active NPI

Gundersen Clinic LTD

  • Long Term Care Pharmacy
  • La Crosse, WI
National Provider Identifier
1699225474
Registry record updated Jul 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
9420-42 Issued in WI
Legal business name
GUNDERSEN CLINIC LTD
Practice address
505 King St Ste 154
La Crosse, WI 54601-4062
Phone
(608) 782-4448
Fax
(608) 782-4449
NPI assigned
Oct 5, 2016
Organization subpart
Yes
Parent organization
GUNDERSEN CLINIC LTDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 4, 2025

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

Authorized official

Name
Tina Lechnir
Title
VP Cross-Functional Care
Phone
(608) 775-2600

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Long Term Care Pharmacy 3336L0003X 9420-42 WI Primary

Addresses

Primary practice location

505 King St Ste 154
La Crosse, WI 54601-4062

Mailing address

505 King St Ste 154
La Crosse, WI 54601-4062
Phone (608) 782-4448

Other identifiers 2

IdentifierTypeStateIssuer
2163999OtherPK
100064708MedicaidWI

Other names 2

  • Gundersen Long Term Care Pharmacy Doing business as
  • Medpak Pharmacy Gundersen Health System Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20170301001027 WI DME Supplier - Pharmacy 9638082779 Practice locations: La Crosse, WI
O20170316002152 WI Part B Supplier - Mass Immunization (Roster Biller Only) 9638082779 5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Onalaska, WI; Tomah, WI; La Crosse, WI; Holmen, WI

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
Gundersen Clinic LTD505 King St, La Crosse, WI 54601-4062(608) 782-4448 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
La Liberte-Gundersen VI52 organizations share this tax ID, including this one
Part of
La Liberte-Gundersen VI

Organizations with this tax ID in the same state 19

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1475625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751587200000",
    "number": "1699225474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 KING ST STE 154",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546014062",
            "telephone_number": "608-782-4448",
            "fax_number": "608-782-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 KING ST STE 154",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546014062",
            "telephone_number": "608-782-4448",
            "fax_number": "608-782-4449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUNDERSEN CLINIC LTD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GUNDERSEN CLINIC LTD",
        "enumeration_date": "2016-10-05",
        "last_updated": "2025-07-04",
        "certification_date": "2025-07-04",
        "status": "A",
        "authorized_official_last_name": "LECHNIR",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "VP CROSS-FUNCTIONAL CARE",
        "authorized_official_telephone_number": "608-775-2600"
    },
    "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": "9420-42",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2163999",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100064708",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gundersen Long Term Care Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Medpak Pharmacy Gundersen Health System",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in La Crosse, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2025; 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.