GUNDERSEN CLINIC LTD. NPI 1164433660

NPI Information

NPI: 1164433660
Provider Name: GUNDERSEN CLINIC, LTD.

Other Name: GUNDERSEN PHARMACY - EAST BUILDING

Classification: Pharmacy - 3336C0002X
Entity Type: Organization

Specialization: Clinic Pharmacy

Address:
724 DENTON ST
LA CROSSE, WI
ZIP 54601
Phone: (608) 775-1000
Get Directions

GUNDERSEN CLINIC, LTD. is a clinic pharmacy pharmacy in La Crosse, WI. The provider is a pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. GUNDERSEN CLINIC, LTD. NPI is 1164433660. The provider is registered as an organization entity type.
The provider Other Name Is Gundersen Pharmacy - East Building.

The provider's business location address is:

724 DENTON ST
LA CROSSE, WI
ZIP 54601-447
Phone: (608) 775-1000
Fax: (608) 775-1010

The provider's authorized official is Loren Carrell .
The authorized official title is Director Of Pharmacy and has the following contact phone number (608) 775-6369.

The enumeration date for this NPI number is 8/10/2006 and was last updated on 4/18/2024.

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
1	333600000X	Pharmacy		8317042	WISCONSIN	No
2	3336C0002X	Pharmacy	Clinic Pharmacy	263512	MINNESOTA	Yes
3	3336C0003X	Pharmacy	Community/Retail Pharmacy			No

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
1	33270300	MEDICAID	WISCONSIN
2	2110059	OTHER		PK

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: 4/28/2024

NPI Synchronization or Removal

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