Gundersen Pharmacy - East Building

LBN: Gundersen Clinic, Ltd.
Gundersen Pharmacy - East Building is an health care organization with primary practice located at 724 Denton St , La Crosse WI 54601-5447. 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) 775-1000, or through Carrell, Loren via phone (608) 775-6369.

Contact Information

Primary practice address
724 Denton St La Crosse WI 54601-5447
Fax: (608) 775-1010
Website:
Authorized official contact:
Name: Carrell, Loren RPH

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X 8317042 Wisconsin
Suppliers / Clinic Pharmacy 3336C0002X 263512 Minnesota
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1164433660
LBN Legal business name Gundersen Clinic, Ltd.
DBA Doing business as Gundersen Pharmacy - East Building
Authorized official Carrell, Loren RPH
Entity Organization
Organization subpart 1 Yes
Enumeration date Aug 10th, 2006
Last updated Apr 18th, 2024 - about 7 months ago

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 1164433660 NPPES
Wisconsin MEDICAID 33270300
Wisconsin Other 2110059

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