NPIMap

Organization Active NPI

Maplewood of Sauk Prairie

  • Long Term Care Pharmacy
  • Sauk City, WI
National Provider Identifier
1821081936
Registry record updated Oct 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
MAPLEWOOD OF SAUK PRAIRIE
Doing business as
Maplewood of Sauk Prairie
Practice address
245 Sycamore Steet
Sauk City, WI 53583
Phone
(608) 644-9265
Fax
(608) 643-2629
NPI assigned
Aug 24, 2005
Last updated
Oct 24, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2018

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

Authorized official

Name
Mr. Richard Carl Harris, R.PH.
Title
Staff Pharmacist
Phone
(608) 644-9265

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

245 Sycamore Steet
Sauk City, WI 53583

Mailing address

245 Sycamore Steet
Sauk City, WI 53583
Phone (608) 644-9265

Other identifiers 2

IdentifierTypeStateIssuer
33204100MedicaidWI
2113946OtherPK

Other names 1

  • MAPLEWOOD OF SAUK PRAIRIE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Maplewood of Sauk Prairie2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1124841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540339200000",
    "number": "1821081936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 SYCAMORE STEET",
            "city": "SAUK CITY",
            "state": "WI",
            "postal_code": "53583",
            "telephone_number": "608-644-9265",
            "fax_number": "608-643-2629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 SYCAMORE STEET",
            "city": "SAUK CITY",
            "state": "WI",
            "postal_code": "53583",
            "telephone_number": "608-644-9265",
            "fax_number": "608-643-2629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLEWOOD OF SAUK PRAIRIE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-24",
        "last_updated": "2018-10-24",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "CARL",
        "authorized_official_title_or_position": "STAFF PHARMACIST",
        "authorized_official_telephone_number": "608-644-9265",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33204100",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2113946",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MAPLEWOOD OF SAUK PRAIRIE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MAPLEWOOD OF SAUK PRAIRIE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sauk City, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2018; 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.