Organization Active NPI

Thomas a Christianson

  • Durable Medical Equipment & Medical Supplies
  • Portage, WI
National Provider Identifier
1720162068
Registry record updated Jul 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
6336 Issued in WI
Legal business name
THOMAS A CHRISTIANSON
Practice address
117 E Cook St
Portage, WI 53901-2204
Phone
(608) 742-3737
Fax
(608) 742-0216
NPI assigned
Oct 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2008

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

Authorized official

Name
Thomas Christianson, R.PH.
Title
Owner/Pharmacist
Phone
(608) 742-3737

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 9631-040 WI
Durable Medical Equipment & Medical Supplies 332B00000X 6336 WI Primary

Addresses

Primary practice location

117 E Cook St
Portage, WI 53901-2204

Mailing address

117 E Cook St
Portage, WI 53901-2204
Phone (608) 742-3737

Other identifiers 1

IdentifierTypeStateIssuer
33054700MedicaidWI

Other names 1

  • Rhyme Drug Doing business as

National Provider Directory

National Provider Directory

Locations

117 E Cook St
Portage, WI 53901
Phone (608) 742-3737

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215734400000",
    "number": "1720162068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 E COOK ST",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539012204",
            "telephone_number": "608-742-3737",
            "fax_number": "608-742-0216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 E COOK ST",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539012204",
            "telephone_number": "608-742-3737",
            "fax_number": "608-742-0216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS A CHRISTIANSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2008-07-11",
        "status": "A",
        "authorized_official_last_name": "CHRISTIANSON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "608-742-3737",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "9631-040",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "WI",
            "license": "6336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33054700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rhyme Drug",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portage, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2008; 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.