Gundersen Clinic Ltd

LBN: Gundersen Clinic Ltd
Gundersen Clinic Ltd is an health care organization with primary practice located at 1836 South Ave , La Crosse WI 54601-5429. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Community/Retail Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Specialty Pharmacy is the primary health care specialty. Gundersen Clinic Ltd can be contacted via phone (608) 782-7300, or through Carrell, Loren via phone (608) 775-6369.

Contact Information

Primary practice address
1836 South Ave La Crosse WI 54601-5429
Fax:
Website:
Authorized official contact:
Name: Carrell, Loren RPH

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X
Suppliers / Specialty Pharmacy 3336S0011X

Profile Details

NPI number 1285351429
LBN Legal business name Gundersen Clinic Ltd
DBA Doing business as
Authorized official Carrell, Loren RPH
Entity Organization
Organization subpart 1 Yes
Enumeration date Oct 27th, 2022
Last updated Oct 27th, 2022 - about 2 years 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 1285351429 NPPES
Other 2112770 PK
MEDICAID 33096300 PK

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