Brandon Wolberg, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

22076-40 Issued in WI

Practice address

701 E Reed Ave
Manitowoc, WI 54220-2129

Phone

(262) 253-5056

NPI assigned

Dec 30, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wisconsin CVS Pharmacy LLC

  • Pharmacy
  • Glendale, WI
  • NPI 1649947573
  NPD (past)

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

{
    "created_epoch": "1672358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672358400000",
    "number": "1831802313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 E REED AVE",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542202129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E REED AVE",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542202129",
            "telephone_number": "262-253-5056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLBERG",
        "first_name": "BRANDON",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-30",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "22076-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim F Winkler, C.O.T.A.
• Jan Marie Wirth, BC-HIS
• Wisconsin CVS Pharmacy LLC
• Wisconsin Lutheran Child & Family Service, Inc.
• Lori Beth Woitkovich, M.A. CCC-SLP
• Mark Frederick Wollum, P.T.
• Womens Health Care Associates, LTD
• John Andrew Woodcock, P.T.A.
• Melissa Mae Wright, RN
• Stephanie Wright, PTA

• Pharmacist in Manitowoc, WI
• Providers in Manitowoc, WI by specialty
• Pharmacist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2022; 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.