Thedacare, Incorporated

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

8673-42 Issued in WI

Legal business name

THEDACARE, INCORPORATED

Practice address

100 County Road B
Shawano, WI 54166-7072

Phone

(715) 526-3456

Fax

(715) 524-5627

NPI assigned

Sep 6, 2006

Organization subpart

No

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

Authorized official

Name

Trini Senzig, PHARMD

Title

Business Manager

Phone

(715) 524-1464

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• THEDA CARE PHARMACY Doing business as

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459209600000",
    "number": "1982707089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 COUNTY ROAD B",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541667072",
            "telephone_number": "715-526-3456",
            "fax_number": "715-524-5627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COUNTY ROAD B",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541667072",
            "telephone_number": "715-526-3456",
            "fax_number": "715-524-5627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEDACARE, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2016-03-29",
        "status": "A",
        "authorized_official_last_name": "SENZIG",
        "authorized_official_first_name": "TRINI",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "715-524-1464",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "8673-42",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2114258",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33239800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THEDA CARE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Thedacare Medical Center - Shawano, Inc.
• Thedacare Medical Center - Shawano, Inc.
• Thedacare Medical Center - Shawano, Inc.
• Thedacare Medical Center - Shawano, Inc.
• Thedacare, Incorporated
• Paul Michael Theuerkauf, P.T.
• Nicholas Thiel, PTA
• Shantel Thomas
• Thomas Thomas, MD
• Bentley Jessica Mae Thomason, MD

• Community/Retail Pharmacy in Shawano, WI
• Providers in Shawano, WI by specialty
• Community/Retail Pharmacy in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.