Gundersen Pharmacy - Cass Street
LBN: Gundersen Clinic Ltd
Gundersen Pharmacy - Cass Street is an health care organization with primary practice located at 528 Cass St , La Crosse WI 54601-4507. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Clinic Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Gundersen Clinic Ltd can be contacted via phone (608) 784-9922, or through Carrell, Loren via phone (608) 775-6369.
Contact Information
Primary practice address
528 Cass St
La Crosse WI 54601-4507
Phone: (608) 784-9922
Fax: (608) 784-2212
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Clinic Pharmacy | 3336C0002X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 9419-42 | Wisconsin |
Profile Details
| NPI number | 1548710627 |
|---|---|
| LBN Legal business name | Gundersen Clinic Ltd |
| DBA Doing business as | Gundersen Pharmacy - Cass Street |
| Authorized official | Carrell, Loren |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | Oct 12th, 2016 |
| Last updated | Apr 19th, 2024 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548710627 | NPPES |
| Wisconsin | MEDICAID | 100063781 | |
| Wisconsin | MEDICAID | 1548710627 | |
| Wisconsin | Other | 2163891 |
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