NPIMap

Organization Active NPI

Surety Pro Pharmacy LLC

  • Long Term Care Pharmacy
  • Greenfield, WI
National Provider Identifier
1942589445
Registry record updated Oct 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
9083-42 Issued in WI
Legal business name
SURETY PRO PHARMACY LLC
Practice address
9200 W Layton Ave
Greenfield, WI 53228-3348
Phone
(414) 433-0188
Fax
(414) 433-0292
NPI assigned
Aug 15, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2016

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

Authorized official

Name
Mr. Gary P. Olszewski, RPHNPI 1215429634
Title
Vice President Pharmacy
Phone
(414) 433-0188

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Long Term Care Pharmacy 3336L0003X 9083-42 WI Primary

Addresses

Primary practice location

9200 W Layton Ave
Greenfield, WI 53228-3348

Mailing address

PO Box 9830
Salt Lake City, UT 84109-9830
Phone (877) 540-4748

Other identifiers 1

IdentifierTypeStateIssuer
2131230OtherPK

Other names 1

  • Surety Pro Pharmacy LLC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1313366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477267200000",
    "number": "1942589445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9830",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841099830",
            "telephone_number": "877-540-4748",
            "fax_number": "801-716-4872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W LAYTON AVE",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532283348",
            "telephone_number": "414-433-0188",
            "fax_number": "414-433-0292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURETY PRO PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-15",
        "last_updated": "2016-10-24",
        "status": "A",
        "authorized_official_last_name": "OLSZEWSKI",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "VICE PRESIDENT PHARMACY",
        "authorized_official_telephone_number": "414-433-0188",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "WI",
            "license": "9083-42",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2131230",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Surety Pro Pharmacy LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenfield, WI

Sources for this page

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