Gundersen Pharmacy - La Crosse Clinic

LBN: Gundersen Clinic Ltd
Gundersen Pharmacy - La Crosse Clinic is an health care organization with primary practice located at 1836 South Ave , La Crosse WI 54601-5429. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Clinic Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Clinic Pharmacy is the primary health care specialty. Gundersen Clinic Ltd can be contacted via phone (608) 775-5595, or through Carrell, Loren via phone (608) 775-6369.

Contact Information

Primary practice address
1836 South Ave La Crosse WI 54601-5429
Phone: (608) 775-5595
Fax: (608) 775-4445
Website:
Map and Directions
Authorized official contact:
Name: Carrell, Loren RPH
Phone: (608) 775-6369

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X 4884 Wisconsin
Suppliers / Clinic Pharmacy 3336C0002X 263208 Minnesota
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1073526661
LBN Legal business name Gundersen Clinic Ltd
DBA Doing business as Gundersen Pharmacy - La Crosse Clinic
Authorized official Carrell, Loren RPH
Entity Organization
Organization subpart 1 Yes
Enumeration date Aug 14th, 2006
Last updated Apr 18th, 2024 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073526661 NPPES
Other 2112770 PK
MEDICAID 33096300 PK

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