Organization Active NPI

Miravida Living Inc

  • Long Term Care Pharmacy
  • Oshkosh, WI
National Provider Identifier
1700874591
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
827342 Issued in WI
Legal business name
MIRAVIDA LIVING INC
Practice address
225 N Eagle St
Oshkosh, WI 54902-4125
Phone
(920) 966-1345
Fax
(920) 966-1285
NPI assigned
Oct 6, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Authorized official

Name
Kerri L Schueler, PHARMDNPI 1699896522
Title
Director of Pharmacy
Phone
(920) 966-1345

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X
Long Term Care Pharmacy 3336L0003X 827342 WI Primary

Addresses

Primary practice location

225 N Eagle St
Oshkosh, WI 54902-4125

Mailing address

225 N Eagle St
Oshkosh, WI 54902-4125
Phone (920) 966-1345

Other identifiers 2

IdentifierTypeStateIssuer
2110060OtherPK
33267400MedicaidWI

Other names 1

  • LHO PHARMACY LLC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210421002684 WI Part B Supplier - Mass Immunization (Roster Biller Only) 9537283940 Practice locations: Oshkosh, WI

National Provider Directory

National Provider Directory

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Bethel Home, Inc.Oshkosh, WI, CCN 525554 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)
Jan 1, 1965
Jan 1, 1965

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786492800000",
    "number": "1700874591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 N EAGLE ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549024125",
            "telephone_number": "920-966-1345",
            "fax_number": "920-966-1285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 N EAGLE ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549024125",
            "telephone_number": "920-966-1345",
            "fax_number": "920-966-1285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRAVIDA LIVING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-06",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A",
        "authorized_official_last_name": "SCHUELER",
        "authorized_official_first_name": "KERRI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "920-966-1345",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "WI",
            "license": "827342",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2110060",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33267400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LHO PHARMACY LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oshkosh, WI

Sources for this page

Verify at the official NPI Registry.