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AGNESIAN HEALTHCARE ENTERPRISES LLC NPI 1174145031


NPI Information

NPI: 1174145031
Provider Name: AGNESIAN HEALTHCARE ENTERPRISES LLC

Doing Business As: AGNESIAN PHARMACY WAUPUN

Classification: Pharmacy - 3336L0003X
Entity Type: Organization

Specialization: Long Term Care Pharmacy

Address:
904 W MAIN ST
WAUPUN, WI
ZIP 53963
Phone: (920) 324-8703
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AGNESIAN HEALTHCARE ENTERPRISES LLC is a long term care pharmacy pharmacy in Waupun, WI. The provider is a pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. AGNESIAN HEALTHCARE ENTERPRISES LLC NPI is 1174145031. The provider is registered as an organization entity type.
The provider Is Doing Business As Agnesian Pharmacy Waupun.

The provider's business location address is:

904 W MAIN ST
WAUPUN, WI
ZIP 53963-201
Phone: (920) 324-8703
Fax: (920) 324-3476

The provider's authorized official is Kimberly Spencer .
The authorized official title is System Vp Pharmacy Services and has the following contact phone number (920) 926-6011.

The enumeration date for this NPI number is 5/14/2020 and was last updated on 6/7/2023.


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
13336L0003XPharmacyLong Term Care PharmacyYes

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
133272300MEDICAIDWISCONSIN

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.