FROEDTERT & MCW MOORLAND RESERVE HEALTH CENTER PHARMACY
NPI 1063874824
Pharmacy - Community/Retail Pharmacy in New Berlin, WI
NPI Status: Active since March 22, 2016
Contact Information
4805 S MOORLAND RD RM G0502A
NEW BERLIN, WI
ZIP 53151
Phone: (262) 798-7386
Fax: (262) 798-7320
- Organization
- Pharmacy
- Community/Retail Pharmacy
- Accepts Insurance
- CLIA Number: 52D2128531
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 04-02-2027
About FROEDTERT & MCW MOORLAND RESERVE HEALTH CENTER PHARMACY
This page provides the complete NPI Profile along with additional information for Froedtert & Mcw Moorland Reserve Health Center Pharmacy, a provider established in New Berlin, Wisconsin operating as a Pharmacy, focusing in community/retail pharmacy . The healthcare provider is registered in the NPI registry with number 1063874824 assigned on March 2016. The practitioner's primary taxonomy code is 3336C0003X with license number 9396-42 (WI). The provider is registered as an organization and their NPI record was last updated 9 years ago. The provider's is doing business as Froedtert & Mcw Moorland Reserve Health Center Pharmacy. The authorized official of this NPI record is Kevin Perhach (Business Manager)
- NPI
- 1063874824
- Provider Legal Name
- COMMUNITY MEMORIAL HOSPITAL OF MENOMONEE FALLS INC
- Other Organization Name
- FROEDTERT & MCW MOORLAND RESERVE HEALTH CENTER PHARMACY
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 4805 S MOORLAND RD RM G0502A NEW BERLIN, WI 53151
- Location Phone
- (262) 798-7386
- Location Fax
- (262) 798-7320
- Mailing Address
- N86W12999 NIGHTINGALE WAY MENOMONEE FALLS, WI 53051
- Mailing Phone
- (262) 532-5173
- Mailing Fax
- (262) 798-7320
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-22-2016
- Last Update Date
- 07-28-2016
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pharmacy Community/Retail Pharmacy
- Taxonomy Code
- 3336C0003X
- Type
- Suppliers
- License No.
- 9396-42
- License State
- WI
- Taxonomy Description
- A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 333600000X | Suppliers | Pharmacy | |
| 2 | 3336C0002X | Suppliers | Pharmacy |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Balance by Medica Bronze $0 Copay PCP Visits - EPO
- Balance by Medica Bronze Premier - EPO
- Balance by Medica Catastrophic - EPO
- Balance by Medica Expanded Bronze Standard - EPO
- Balance by Medica Gold $0 Copay PCP Visits - EPO
- Balance by Medica Gold Share - EPO
- Balance by Medica Gold Standard - EPO
- Balance by Medica Silver $0 Copay PCP Visits - EPO
- Balance by Medica Silver Share - EPO
- Balance by Medica Silver Standard - EPO
- Medica with MU Health Care Bronze $0 Copay PCP Visits - EPO
- Medica with MU Health Care Bronze Premier - EPO
- Medica with MU Health Care Catastrophic - EPO
- Medica with MU Health Care Expanded Bronze Standard - EPO
- Medica with MU Health Care Gold $0 Copay PCP Visits - EPO
- Medica with MU Health Care Gold Share - EPO
- Medica with MU Health Care Gold Standard - EPO
- Medica with MU Health Care Silver $0 Copay PCP Visits - EPO
- Medica with MU Health Care Silver Share - EPO
- Medica with MU Health Care Silver Standard - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1063874824 | MEDICAID (05) | WI | |
| 2158809 | OTHER (01) | PK |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 52D2128531
- Facility Type
- Physician Office
- Certificate Effective Date
- April 03, 2025
- Certificate Expiration Date
- April 02, 2027
- Laboratory Director
- DR. TARA KENNEDY
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Froedtert & Mcw Moorland Reserve Health Center Pharmacy in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
Reviews for FROEDTERT & MCW MOORLAND RESERVE HEALTH CENTER PHARMACY
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 0 | 6 | 3 | 8 | 7 | 4 | 8 | 2 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 12 | 3 | 16 | 7 | 8 | 8 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 1 + 2 + 3 + 1 + 6 + 7 + 8 + 8 + 4 + 24 = 66 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 66 = 4 | 4 | ||||||||
The NPI number 1063874824 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following provider is registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1780232975 | FROEDTERT HEALTH PHARMACY LLC Organization | Pharmacy (Community/Retail Pharmacy) | 4805 S MOORLAND RD RM G0502A NEW BERLIN, WI 53151 (262) 798-7386 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1063874824, enumerated in the NPI registry as an "organization" on March 22, 2016
The provider is located at 4805 S Moorland Rd Rm G0502a New Berlin, Wi 53151 and the phone number is (262) 798-7386
This medical organization specializes in Pharmacy with taxonomy code 3336C0003X with a focus in Community/Retail Pharmacy
The provider might be accepting Accepts: Medica, Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 52D2128531 for a "physician office" facility with a CLIA Certificate for Provider-Performed Microscopy Procedures (PPMP). This CLIA certificate is issued in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing..
This NPI record was last updated on March 22, 2016. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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