St Clare Memorial Hospital Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

9179-42 Issued in WI

Legal business name

ST CLARE MEMORIAL HOSPITAL INC

Doing business as

HSHS St. Clare Memorial Hospital Pharmacy Gillett

Practice address

117 N McKenzie St
Gillett, WI 54124-9142

Phone

(920) 848-6323

Fax

(920) 848-8502

NPI assigned

Jan 28, 2013

Last updated

Dec 23, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Patricia Allen

Title

Cfo

Phone

(920) 884-5660

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• HSHS St. Clare Memorial Hospital Pharmacy Gillett Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1359331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640217600000",
    "number": "1710225693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 N MCKENZIE ST",
            "address_2": "PO BOX 558",
            "city": "GILLETT",
            "state": "WI",
            "postal_code": "541249142",
            "telephone_number": "920-848-6323",
            "fax_number": "920-848-8502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 N MCKENZIE ST",
            "city": "GILLETT",
            "state": "WI",
            "postal_code": "541249142",
            "telephone_number": "920-848-6323",
            "fax_number": "920-848-8502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST CLARE MEMORIAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-28",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "920-884-5660"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "9179-42",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000027937",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2138350",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "community_memorial_hospital_transitions_of_care2201223@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "117 N McKenzie St",
            "city": "Gillett",
            "state": "WI",
            "country_code": "US",
            "postal_code": "541249142",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "HSHS St. Clare Memorial Hospital Pharmacy Gillett",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HSHS St. Clare Memorial Hospital Pharmacy Gillett",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Renee Marie Melotik
• Renee Mueller
• New View Opportunity Center (New View Industries)
• Amelia Jean Rice
• Carrie Schneider, PTA
• St Clare Memorial Hospital, Inc (St Clare Memorial Hospital Gillett Health Center)
• St Clare Memorial Hospital, Inc (St Clare Memorial Hosptial Physical Therapy Gillett Health Center)
• St Vincent Hospital-Hospital Sisters-Third Order of St Francis (St. Vincent Hospital-Libertas of Gillett)
• The Caring Doctor, LLC
• Megan Valley

• Community/Retail Pharmacy in Gillett, WI
• Providers in Gillett, WI by specialty
• Community/Retail Pharmacy in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2021; 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.