Mayo Clinic Health System - Pharmacy & Home Medical, Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

8530 Issued in WI

Legal business name

MAYO CLINIC HEALTH SYSTEM - PHARMACY & HOME MEDICAL, INC

Doing business as

Mayo Clinic Store Westgate

Practice address

1707 Westgate Rd
Eau Claire, WI 54703-4964

Phone

(715) 838-5861

NPI assigned

Jul 31, 2006

Organization subpart

No

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

Authorized official

Name

Julie S Hansen

Title

Cfo

Phone

(715) 838-5270

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Mayo Clinic Store Westgate Doing business as

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1942216361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 2ND ST SW STE 118",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559023197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 WESTGATE RD",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547034964",
            "telephone_number": "715-838-5861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYO CLINIC HEALTH SYSTEM - PHARMACY & HOME MEDICAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "715-838-5270"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "WI",
            "license": "8530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "51 21013",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33184700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mayo Clinic Store Westgate",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Leland Robert Mayer, MD
• Charles Andre Mayeux, DO
• Mayo Clinic Health System - Pharmacy & Home Medical Inc
• Mayo Clinic Health System - Pharmacy & Home Medical, Inc
• Mayo Clinic Health System - Pharmacy & Home Medical, Inc
• Mayo Clinic Health System - Pharmacy & Home Medical, Inc.
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

• Durable Medical Equipment & Medical Supplies in Eau Claire, WI
• Providers in Eau Claire, WI by specialty
• Durable Medical Equipment & Medical Supplies in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.