NPIMap

Organization Active NPI

Spooner Health System

Doing business as Spooner Health Pharmacy

  • Institutional Pharmacy
  • Spooner, WI
National Provider Identifier
1942245188
Registry record updated Aug 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Institutional PharmacyTaxonomy code 3336I0012X
License
9407-42 Issued in WI
Legal business name
SPOONER HEALTH SYSTEM
Doing business as
Spooner Health Pharmacy
Practice address
1280 Chandler Drive
Spooner, WI 54801-1299
Phone
(715) 939-1746
Fax
(715) 939-1562
NPI assigned
Jun 20, 2006
Last updated
Aug 16, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2016

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

Authorized official

Name
Tim Bassett, RPH
Title
Dir of Pharmacy
Phone
(715) 939-1746

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Institutional Pharmacy 3336I0012X 9407-42 WI Primary

Addresses

Primary practice location

1280 Chandler Drive
Spooner, WI 54801-1299

Mailing address

1280 Chandler Drive
Spooner, WI 54801
Phone (715) 939-1746

Other identifiers 2

IdentifierTypeStateIssuer
2113053OtherPK
33132300MedicaidWI

Other names 1

  • SPOONER HEALTH PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Spooner Heatlh System3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471305600000",
    "number": "1942245188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1280 CHANDLER DRIVE",
            "city": "SPOONER",
            "state": "WI",
            "postal_code": "54801",
            "telephone_number": "715-939-1746",
            "fax_number": "715-939-1562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1280 CHANDLER DRIVE",
            "city": "SPOONER",
            "state": "WI",
            "postal_code": "548011299",
            "telephone_number": "715-939-1746",
            "fax_number": "715-939-1562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPOONER HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2016-08-16",
        "status": "A",
        "authorized_official_last_name": "BASSETT",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "DIR OF PHARMACY",
        "authorized_official_telephone_number": "715-939-1746",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "WI",
            "license": "9407-42",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2113053",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33132300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SPOONER HEALTH PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spooner, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2016; 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.