Organization Active NPI

Mayville Hometown Pharmacy LLC

Doing business as Mayville Hometown Pharmacy

  • Community/Retail Pharmacy
  • Mayville, WI
National Provider Identifier
1790244473
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
MAYVILLE HOMETOWN PHARMACY LLC
Doing business as
Mayville Hometown Pharmacy
Practice address
1448 Horicon St
Mayville, WI 53050-1467
Phone
(920) 644-2080
Fax
(920) 644-2208
NPI assigned
Mar 13, 2019
Last updated
Sep 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Authorized official

Name
Daniel Strause
Title
Owner
Phone
(920) 992-6800

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Primary
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

1448 Horicon St
Mayville, WI 53050-1467

Mailing address

333 Lowville Rd
Rio, WI 53960-9437
Phone (920) 992-6800

Other identifiers 1

IdentifierTypeStateIssuer
100087577MedicaidWI

Other names 1

  • MAYVILLE HOMETOWN PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190523000710 WI Part B Supplier - Pharmacy 0345583951 Practice locations: Mayville, WI
O20190826002845 WI DME Supplier - Pharmacy 0345583951 Practice locations: Mayville, WI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D2196195Mayville Hometown Pharmacy LLC1448 Horicon St, Mayville, WI 53050Certificate of waiverOct 14, 2026

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Mayville Hometown Pharmacy LLC1448 Horicon St, Mayville, WI 53050-1467(920) 644-2080 Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Walkers|Wheelchair Seating/Cushions|Orthoses: Off-The-Shelf|Ostomy Supplies|Urological Suppl… Accepts assignmentParticipating since May 22, 2019

National Provider Directory

National Provider Directory

Locations

1448 Horicon St
Mayville, WI 53050
Phone (920) 644-2080

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1552435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757030400000",
    "number": "1790244473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 LOWVILLE RD",
            "city": "RIO",
            "state": "WI",
            "postal_code": "539609437",
            "telephone_number": "920-992-6800",
            "fax_number": "920-614-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1448 HORICON ST",
            "city": "MAYVILLE",
            "state": "WI",
            "postal_code": "530501467",
            "telephone_number": "920-644-2080",
            "fax_number": "920-644-2208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYVILLE HOMETOWN PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-13",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A",
        "authorized_official_last_name": "STRAUSE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-992-6800"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "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": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100087577",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MAYVILLE HOMETOWN PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MAYVILLE HOMETOWN PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mayville, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.