Petco Wellness LLC

Primary specialty

Mail Order PharmacyTaxonomy code 3336M0002X

License

9291-42 Issued in WI

Legal business name

PETCO WELLNESS LLC

Doing business as

Doctors Foster and Smith Pharmacy

Practice address

2253 Air Park Rd
Rhinelander, WI 54501-8425

Phone

(800) 447-3021

Fax

(800) 447-2404

NPI assigned

Jul 31, 2006

Last updated

Jun 17, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Darragh Davis

Title

Vice President

Phone

(858) 657-2091

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Doctors Foster and Smith Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466121600000",
    "number": "1992711782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10850 VIA FRONTERA",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921271705",
            "telephone_number": "858-453-7845",
            "fax_number": "858-638-2201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2253 AIR PARK RD",
            "city": "RHINELANDER",
            "state": "WI",
            "postal_code": "545018425",
            "telephone_number": "800-447-3021",
            "fax_number": "800-447-2404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETCO WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2016-06-17",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "DARRAGH",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "858-657-2091"
    },
    "taxonomies": [
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "WI",
            "license": "9291-42",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2150646",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Doctors Foster and Smith Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lauren Nicole Pavlik, PHARMD
• Heather A Pelock Hjelle, APNP BC
• Danielle Perner, DPT
• James P Perra
• Tammery M Perry, APNP
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• Nicole Marie Peterson, FNP-C

• Mail Order Pharmacy in Rhinelander, WI
• Providers in Rhinelander, WI by specialty
• Mail Order Pharmacy in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.