NPIMap

Organization Active NPI

Morton Drug Co Inc

Doing business as Morton LTC Oshkosh

  • Community/Retail Pharmacy
  • Oshkosh, WI
National Provider Identifier
1801985585
Registry record updated Apr 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
900942 Issued in WI
Legal business name
MORTON DRUG CO INC
Doing business as
Morton LTC Oshkosh
Practice address
129 Jackson St
Oshkosh, WI 54901-4713
Phone
(920) 651-4236
Fax
(920) 651-0971
NPI assigned
Oct 12, 2006
Last updated
Apr 2, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2012

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

Authorized official

Name
Jeffrey Blank
Title
VP Corporate Services
Phone
(920) 727-8882

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X 900942 WI Primary

Addresses

Primary practice location

129 Jackson St
Oshkosh, WI 54901-4713

Mailing address

PO Box 778
Neenah, WI 54957-0778
Phone (920) 727-3853

Other identifiers 2

IdentifierTypeStateIssuer
33234900MedicaidWI
5116252OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • MORTON LTC OSHKOSH Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090528000558 WI Part B Supplier - Mass Immunization (Roster Biller Only) 7113076860 12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Neenah, WI

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

135 Jackson St
Oshkosh, WI 54901
Phone (920) 236-3277

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333324800000",
    "number": "1801985585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 778",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549570778",
            "telephone_number": "920-727-3853",
            "fax_number": "920-727-3867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 JACKSON ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549014713",
            "telephone_number": "920-651-4236",
            "fax_number": "920-651-0971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORTON DRUG CO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2012-04-02",
        "status": "A",
        "authorized_official_last_name": "BLANK",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "VP CORPORATE SERVICES",
        "authorized_official_telephone_number": "920-727-8882"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "900942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33234900",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5116252",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MORTON LTC OSHKOSH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oshkosh, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.