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AGNESIAN HEALTHCARE ENTERPRISES LLC NPI 1366417917


NPI Information

NPI: 1366417917
Provider Name: AGNESIAN HEALTHCARE ENTERPRISES LLC

Doing Business As: AGNESIAN PHARMACY WAUPUN

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
904 W MAIN ST
WAUPUN, WI
ZIP 53963
Phone: (920) 324-3010
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AGNESIAN HEALTHCARE ENTERPRISES LLC is a community/retail pharmacy pharmacy in Waupun, WI. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. AGNESIAN HEALTHCARE ENTERPRISES LLC NPI is 1366417917. 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) 324-3010
Fax: (920) 324-3875

The provider's authorized official is Nancy Hyland .
The authorized official title is Director Retail Pharmacies and has the following contact phone number (920) 926-8723.

The enumeration date for this NPI number is 2/17/2006 and was last updated on 6/20/2016.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13336L0003XPharmacyLong Term Care PharmacyNo
23336C0003XPharmacyCommunity/Retail Pharmacy905642WISCONSINYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
14368240006MEDICARE NSC
233272300MEDICAIDWISCONSIN
32113944OTHERPK

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

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