Community Care Inc

Primary specialty

Managed Care Organization PharmacyTaxonomy code 3336M0003X

License

8638-42 Issued in WI

Legal business name

COMMUNITY CARE INC

Doing business as

Community Care Inc Pharmacy

Practice address

1555 S Layton Blvd
Milwaukee, WI 53215-1924

Phone

(414) 902-2397

Fax

(414) 649-9149

NPI assigned

Aug 18, 2006

Last updated

Oct 24, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Kenneth Munson

Title

Ceo

Phone

(414) 231-4000

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• COMMUNITY CARE INC PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571875200000",
    "number": "1932213923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 S LAYTON BLVD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532151924",
            "telephone_number": "414-902-2397",
            "fax_number": "414-649-9149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 S LAYTON BLVD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532151924",
            "telephone_number": "414-902-2397",
            "fax_number": "414-649-9149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2019-10-24",
        "status": "A",
        "authorized_official_last_name": "MUNSON",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "414-231-4000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Managed Care Organization Pharmacy",
            "state": "WI",
            "license": "8638-42",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100036712",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2110889",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COMMUNITY CARE INC PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "COMMUNITY CARE INC PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; 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.