Wisconsin CVS Pharmacy LLC

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

WISCONSIN CVS PHARMACY LLC

Practice address

102 Central Bridge St
Wausau, WI 54401-2944

Phone

(715) 842-0744

NPI assigned

Jun 12, 2013

Organization subpart

No

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

Authorized official

Name

Susan F Colbert

Title

Director Payer Relations

Phone

(401) 770-2751

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• CVS PHARMACY #10172 Doing business as

Medicare fee-for-service enrollment

Enrolled in WI2 enrollments

Enrollment records 2

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

CLIA laboratory certificates

Medicare medical equipment & supply locations

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• CVS Pharmacy Inc

  • Pharmacy
  • Dallas, TX
  • NPI 1578667366

  Member Of

  NPD member

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kristen Hollys Aschbrenner, PHARMD

  • Pharmacist
  • Wausau, WI
  • NPI 1427644103
  NPD (past)
• Jonathan Peter Mueller, PHARMD

  • Pharmacist
  • Wausau, WI
  • NPI 1447888151
  NPD (past)
• Logan Osness, PHARMD

  • Pharmacist
  • Wausau, WI
  • NPI 1558995936
  NPD (past)
• Wendy Ann Rausch, PHARM D.

  • Pharmacist
  • Wausau, WI
  • NPI 1700498409
  NPD (past)
• Alanis Nicole Rodriguez Colon, PHARMD

  • Pharmacist
  • Wausau, WI
  • NPI 1942131065
  NPD (past)
• Ashley Jennifer Schultz

  • Pharmacy Technician
  • Wausau, WI
  • NPI 1710573514
  NPD (past)
• Diana M Yang

  • Pharmacy Technician
  • Wausau, WI
  • NPI 1407442205
  NPD (past)

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

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384214400000",
    "number": "1831537869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028956146",
            "telephone_number": "401-765-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 CENTRAL BRIDGE ST",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544012944",
            "telephone_number": "715-842-0744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISCONSIN CVS PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-12",
        "last_updated": "2013-11-12",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "DIRECTOR PAYER RELATIONS",
        "authorized_official_telephone_number": "401-770-2751"
    },
    "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": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "5133777",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1831537869",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS PHARMACY #10172",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tyler J Wimmer
• Jessica Jean Wincentsen, APNP
• Maxwell Joseph Wingelaar, MD
• Stephanie Ruth Winker
• Kelly Wirkus, OTR
• Wisconsin Dental Sleep Medicine
• Wisconsin Institute of Sleep Apnea S.C.
• Wisconsin Reproductive Health Network Inc
• Sue Ellyn Wisnewski, MSSW, APSW
• Sara Ann Wisniewski, REGISTERED NURSE

• Pharmacy in Wausau, WI
• Providers in Wausau, WI by specialty
• Pharmacy in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2013; 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.