NPIMap

Organization Active NPI

Thedacare, Incorporated

Doing business as ThedaCare At Home Infusion Pharmacy

  • Home Infusion Therapy Pharmacy
  • Appleton, WI
National Provider Identifier
1699861617
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Infusion Therapy PharmacyTaxonomy code 3336H0001X
License
7196-042 Issued in WI
Legal business name
THEDACARE, INCORPORATED
Doing business as
ThedaCare At Home Infusion Pharmacy
Practice address
1818 N Meade St
Appleton, WI 54911-3454
Phone
(920) 969-0919
Fax
(920) 730-3433
NPI assigned
Oct 5, 2006
Last updated
Jan 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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

Authorized official

Name
William Flett
Title
Cfo
Phone
(920) 454-4013

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Infusion Therapy Pharmacy 3336H0001X 7196-042 WI Primary

Addresses

Primary practice location

1818 N Meade St
Appleton, WI 54911-3454

Mailing address

3 Neenah Ctr
Neenah, WI 54956-3070
Phone (920) 454-4229

Other names 1

  • ThedaCare At Home Infusion Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930066042 WI DME Supplier - Pharmacy 1759294887 Practice locations: Appleton, WI

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
Thedacare, Incorporated1818 N Meade St, Appleton, WI 54911-3454(920) 831-1829 Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|External Infusion Pumps and/or Supplies|Parenteral Nutrients|Parenteral Equipment and/or Supplies Accepts assignmentParticipating since Jan 1, 1999

National Provider Directory

National Provider Directory
Tax ID family
Novus Laboratories20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

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

View all 19

Ownership & related parties

All facility ownership & control disclosures 15

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Thedacare Medical Center - Berlin, Inc.Berlin, WI, CCN 521355 Hospital Operational/Managerial Control (100%) Jun 30, 2014
Thedacare Medical Center - Wild Rose, Inc.Wild Rose, WI, CCN 521303 Hospital Operational/Managerial Control Jul 1, 2014
Thedacare Medical Center - Wild Rose, Inc.Wild Rose, WI, CCN 52Z303 Hospital Operational/Managerial Control Jul 1, 2014
Thedacare Medical Center - Shawano, Inc.Shawano, WI, CCN 521346 Hospital Operational/Managerial Control Jan 30, 2011
Thedacare Medical Center - Shawano, Inc.Shawano, WI, CCN 52Z346 Hospital Operational/Managerial Control Jan 30, 2011
Thedacare Regional Medical Center-Neenah IncNeenah, WI, CCN 520045 Hospital Operational/Managerial Control Jan 19, 2011
Thedacare Regional Medical Center - Appleton, IncAppleton, WI, CCN 520160 Hospital Operational/Managerial Control Nov 22, 2010
Thedacare Medical Center - Waupaca, IncWaupaca, WI, CCN 521334 Hospital Operational/Managerial Control Jun 1, 2006
Thedacare Medical Center - Waupaca, IncWaupaca, WI, CCN 52Z334 Hospital Operational/Managerial Control Jun 1, 2006
Thedacare Medical Center - New London, IncNew London, WI, CCN 521326 Hospital Operational/Managerial Control Jan 1, 2000
Thedacare Medical Center - New London, IncNew London, WI, CCN 52Z326 Hospital Operational/Managerial Control Jan 1, 2000
Thedacare Regional Medical Center - Appleton, IncAppleton, WI, CCN 52T160 Hospital Operational/Managerial Control Jan 1, 2024
Juliette ManorBerlin, WI, CCN 525286 Skilled nursing facility Operational/Managerial Control (100%) Jun 30, 2014
Thedacare Medical Center - Shawano, Inc.Shawano, WI, CCN 528614 Rural health clinic Operational/Managerial Control Jan 19, 2011
Shawano Medical Center IncClintonville, WI, CCN 528608 Rural health clinic Operational/Managerial Control Jan 19, 2011

Owned or controlled facilities with NPI records 30

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704153600000",
    "number": "1699861617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 NEENAH CTR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549563070",
            "telephone_number": "920-454-4229",
            "fax_number": "920-993-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 N MEADE ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549113454",
            "telephone_number": "920-969-0919",
            "fax_number": "920-730-3433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEDACARE, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A",
        "authorized_official_last_name": "FLETT",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "920-454-4013"
    },
    "taxonomies": [
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "WI",
            "license": "7196-042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ThedaCare At Home Infusion Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.