Nicolet Pharmacy

LBN: Nicolet Pharmacy Inc
Nicolet Pharmacy is an health care organization with primary practice located at 15481 Commercial Rd , Lakewood WI 54138-9677. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Nicolet Pharmacy Inc can be contacted via phone (715) 276-3646, or through Donaldson, Gary via phone (715) 276-3646.

Contact Information

Primary practice address
15481 Commercial Rd Lakewood WI 54138-9677
Phone: (715) 276-3646
Fax: (715) 276-9568
Website:
Map and Directions
Authorized official contact:
Name: Donaldson, Gary
Phone: (715) 276-3646

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Community/Retail Pharmacy 3336C0003X 757642 Wisconsin
Suppliers / Compounding Pharmacy 3336C0004X

Profile Details

NPI number 1851321566
LBN Legal business name Nicolet Pharmacy Inc
DBA Doing business as Nicolet Pharmacy
Authorized official Donaldson, Gary
Entity Organization
Organization subpart 1 No
Enumeration date Jul 5th, 2006
Last updated Oct 10th, 2019 - about 6 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 1851321566 NPPES
Wisconsin MEDICAID 33214400
Wisconsin Other 2115483

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