Active NPI
Michael A Eannelli Sr., RPH
- Pharmacist
- Prairie Du Sac, WI
National Provider Identifier
1962831552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 9102-40
- Practice address
- 405 Water St
Prairie Du Sac, WI 53578-1126 - Phone
- (608) 643-3396
- Fax
- (608) 643-4361
- NPI assigned
- Nov 5, 2013
- Last updated
- Nov 5, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 9102-40 | WI | Primary |
Addresses
Primary practice location
405 Water St
Prairie Du Sac, WI 53578-1126
Mailing address
405 Water St
Prairie Du Sac, WI 53578-1126
Phone (608) 643-3396
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9102-40 | WI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| E-Scripts, Inc | Current | Accepting new patients | |
| E-Scripts, Inc | Current | Accepting new patients |
Locations
405 Water St
Prairie du Sac, WI 53578
Phone (608) 643-3396
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Long Term Care Pharmacy
- Prairie Du Sac, WI
- NPI 1285484758
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383609600000",
"number": "1962831552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "405 WATER ST",
"city": "PRAIRIE DU SAC",
"state": "WI",
"postal_code": "535781126",
"telephone_number": "608-643-3396",
"fax_number": "608-643-4361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "405 WATER ST",
"city": "PRAIRIE DU SAC",
"state": "WI",
"postal_code": "535781126",
"telephone_number": "608-643-3396",
"fax_number": "608-643-4361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EANNELLI",
"first_name": "MICHAEL",
"middle_name": "A",
"name_prefix": "Mr.",
"name_suffix": "Sr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-11-05",
"last_updated": "2013-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "9102-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prairie Du Sac, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.