NPIMap

Organization Active NPI

Aurora Sinai Medical

Doing business as Johnston Pharmacy

  • Clinic Pharmacy
  • Milwaukee, WI
National Provider Identifier
1720012941
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
6992 Issued in WI
Legal business name
AURORA SINAI MEDICAL
Doing business as
Johnston Pharmacy
Practice address
1230 W Grant St
Milwaukee, WI 53215-2732
Phone
(414) 672-5147
Fax
(414) 384-5578
NPI assigned
Jul 11, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Vicki Soerens
Title
Billing Manager
Phone
(920) 803-3260

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X 6992 WI Primary

Addresses

Primary practice location

1230 W Grant St
Milwaukee, WI 53215-2732

Mailing address

1230 W Grant St
Milwaukee, WI 53215-2732

Other identifiers 2

IdentifierTypeStateIssuer
5118282OtherOTHER ID NUMBER-COMMERCIAL NUMBER
32955300MedicaidWI

Other names 1

  • JOHNSTON PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Aurora Sinai Medical Center Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720012941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 W GRANT ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532152732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 W GRANT ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532152732",
            "telephone_number": "414-672-5147",
            "fax_number": "414-384-5578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AURORA SINAI MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SOERENS",
        "authorized_official_first_name": "VICKI",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "920-803-3260"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "WI",
            "license": "6992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "5118282",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32955300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JOHNSTON PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.