Active NPI
Mark J Eggerichs, R.PH.
- Pharmacist
- Delavan, WI
National Provider Identifier
1972835106
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 9135-040
- Practice address
- 1450 E Geneva St
Delavan, WI 53115-2025 - Phone
- (262) 728-0062
- Fax
- (262) 728-0055
- NPI assigned
- Feb 15, 2010
- Last updated
- Nov 10, 2013
- Sex
- Male
- Sole proprietor
- No
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 | 9135-040 | WI | Primary |
Addresses
Primary practice location
1450 E Geneva St
Delavan, WI 53115-2025
Mailing address
1125 Sundt LN
Stoughton, WI 53589-1284
Phone (608) 873-0268
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 |
|---|---|---|---|
| 9135-040 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384041600000",
"number": "1972835106",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1125 SUNDT LN",
"city": "STOUGHTON",
"state": "WI",
"postal_code": "535891284",
"telephone_number": "608-873-0268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1450 E GENEVA ST",
"city": "DELAVAN",
"state": "WI",
"postal_code": "531152025",
"telephone_number": "262-728-0062",
"fax_number": "262-728-0055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EGGERICHS",
"first_name": "MARK",
"middle_name": "J",
"credential": "R.PH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-02-15",
"last_updated": "2013-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "9135-040",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Delavan, WI
- April Doebert-Fischer, OTR
- Kelly Anne Doering-Kilkenny, LPN
- Dr Howard R Henning SC
- Jean Ellen Duesterbeck, REGISTERED NURSE
- Pascalle Dumez, PT
- Extendicare Homes, Inc. (Willowfield Nursing and Rehabilitation Center)
- Michael J Fehling, MD
- FMG East Geneva Street Wisconsin LLC (Willowfield Nursing & Rehabilitation)
- Jessica Lynne Formea, MS, CFY-SLP
- Nicholas Matthew Franz, PHARMD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.