Active NPI
Thomas a Christianson
- Durable Medical Equipment & Medical Supplies
- Portage, WI
National Provider Identifier
1720162068
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- License
- 6336
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33054700 | Medicaid | WI |
Other names 1
- Rhyme Drug
National Provider Directory
National Provider DirectoryLocations
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.