NPIMap

Organization Active NPI

SKJ Inc.

Doing business as Door Creek Pharmacy

  • Community/Retail Pharmacy
  • Deerfield, WI
National Provider Identifier
1982740544
Registry record updated Sep 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
838342 Issued in WI
Legal business name
SKJ INC.
Doing business as
Door Creek Pharmacy
Practice address
50 N Main St
Deerfield, WI 53531-9353
Phone
(608) 764-8111
Fax
(608) 764-5556
NPI assigned
Jan 30, 2007
Last updated
Sep 22, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2011

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

Authorized official

Name
Kevin HoeyNPI 1770760811
Title
Owner
Phone
(608) 839-3784

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 NU
Community/Retail Pharmacy 3336C0003X 838342 WI Primary

Addresses

Primary practice location

50 N Main St
Deerfield, WI 53531-9353

Mailing address

431 W Cottage Grove Rd
Cottage Grove, WI 53527-9385
Phone (608) 839-3784

Other identifiers 2

IdentifierTypeStateIssuer
5127813OtherNCPDP PROVIDER IDENTIFICATION NUMBER
33274500MedicaidWI

Other names 1

  • DOOR CREEK PHARMACY Doing business as

National Provider Directory

National Provider Directory

Locations

431 W Cottage Grove Rd
Cottage Grove, WI 53527
Phone (608) 839-3784

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316649600000",
    "number": "1982740544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 W COTTAGE GROVE RD",
            "city": "COTTAGE GROVE",
            "state": "WI",
            "postal_code": "535279385",
            "telephone_number": "608-839-3784",
            "fax_number": "608-839-3786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N MAIN ST",
            "city": "DEERFIELD",
            "state": "WI",
            "postal_code": "535319353",
            "telephone_number": "608-764-8111",
            "fax_number": "608-764-5556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKJ INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2011-09-22",
        "status": "A",
        "authorized_official_last_name": "HOEY",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "608-839-3784"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "838342",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5127813",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33274500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DOOR CREEK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Deerfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; 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.