BENEVOLENT CORPORATION CEDAR COMMUNITY NPI 1154321602

NPI Information

  • NPI: 1154321602
  • Provider Name: BENEVOLENT CORPORATION CEDAR COMMUNITY
  • Classification: Pharmacy - 333600000X
  • Entity Type: Organization
  • Doing Business As: CEDAR LAKE CAMPUS PHARMACY
  • Address: 5595 COUNTY ROAD Z
    WEST BEND, WI
    ZIP 53095
  • Phone: (262) 306-2140

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NPI Details

BENEVOLENT CORPORATION CEDAR COMMUNITY is a pharmacy in West Bend, WI. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. BENEVOLENT CORPORATION CEDAR COMMUNITY NPI is 1154321602. The provider is registered as an organization entity type.
The provider Is Doing Business As Cedar Lake Campus Pharmacy.

The provider's business location address is:

5595 COUNTY ROAD Z
WEST BEND, WI
ZIP 53095-224
Phone: (262) 306-2140
Fax: (262) 306-2141

The provider's authorized official is Joseph T Pichler .
The authorized official title is Vice President Of Finance and has the following contact phone number (262) 306-4212.

The enumeration date for this NPI number is 7/27/2005 and was last updated on 12/30/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1333600000XPharmacy5115503WISCONSINYes
23336L0003XPharmacyLong Term Care Pharmacy5115503WISCONSINNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
133027100MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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