THREE LAKES PHARMACY
NPI 1104285907
Pharmacy - Community/Retail Pharmacy in Three Lakes, WI
NPI Status: Active since February 22, 2016
Contact Information
1790 SUPERIOR ST
THREE LAKES, WI
ZIP 54562
Phone: (715) 546-3266
Fax: (715) 546-2912
- Organization
- Pharmacy
- Community/Retail Pharmacy
- Accepts Insurance
About THREE LAKES PHARMACY
This page provides the complete NPI Profile along with additional information for Three Lakes Pharmacy, a provider established in Three Lakes, Wisconsin operating as a Pharmacy, focusing in community/retail pharmacy . The healthcare provider is registered in the NPI registry with number 1104285907 assigned on February 2016. The practitioner's primary taxonomy code is 3336C0003X with license number 9400-42 (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 Three Lakes Pharmacy. The authorized official of this NPI record is Seth Moe (Pharmd)
- NPI
- 1104285907
- Provider Legal Name
- MOE DRUGS LLC
- Other Organization Name
- THREE LAKES PHARMACY
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1790 SUPERIOR ST THREE LAKES, WI 54562
- Location Phone
- (715) 546-3266
- Location Fax
- (715) 546-2912
- Mailing Address
- 1790 SUPERIOR ST THREE LAKES, WI 54562
- Mailing Phone
- (715) 546-3266
- Mailing Fax
- (715) 546-2912
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 02-22-2016
- Last Update Date
- 02-20-2017
- 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.
- 9400-42
- 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 |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- 2025 HMO 1500 Elite Gold - HMO
- 2025 HMO 5000 Elite Silver - HMO
- 2025 HMO 9200 Elite Catastrophic - HMO
- 2025 POS 1000 Elite Gold - POS
- 2025 POS 1500 Elite Gold - POS
- 2025 POS 2500 Elite Gold - POS
- 2025 POS 4200 Elite Silver - POS
- 2025 POS 5000 Elite Silver - POS
- 2025 POS 6500 Elite Bronze - POS
- 2025 POS 7250 Elite Silver - POS
- 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
- Moda Health Affinity Bronze 7750 - EPO
- Moda Health Affinity Bronze 9000 - EPO
- Moda Health Affinity Bronze HDHP 7500 - EPO
- Moda Health Affinity Gold 1000 - EPO
- Moda Health Affinity Gold 1500 - EPO
- Moda Health Affinity Gold 250 - EPO
- Moda Health Affinity Silver 3000 - EPO
- Moda Health Affinity Silver 3400 - EPO
- Moda Health Affinity Silver 4500 - EPO
- Moda Health Affinity Silver 6000 - EPO
- Enrich $1,500 - 25% - HMO
- Enrich $3,500 - 30% - HMO
- Enrich $4,100 HDHP - HMO
- Enrich $5,000 - 40% - HMO
- Enrich $6,200 HDHP - HMO
- Enrich $7,500 - HMO
- Enrich $9,200 - HMO
- Enrich Protection - HMO
- Premier $1,500 - 25% - HMO
- Premier $3,500 - 30% - HMO
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 |
|---|---|---|---|
| 100055480 | MEDICAID (05) | WI | |
| 2158870 | OTHER (01) | PK |
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Adm sarscov2 50mcg/0.25mlbst
Administration of influenza virus vaccine
Fee covid-19 vac 13 res
Fee covid-19 vac 14 res
Influenza vaccine split virus, preservative free
Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage
Influenza vaccine, quadrivalent, preservative free, 0.5 ml dosage
Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count
This procedure involves administering a dose of a SARS-CoV-2 vaccine. The specific dosage is 50 micrograms in a 0.25 milliliter booster shot. This vaccine helps your body build immunity against the COVID-19 virus. It's a key part of global efforts to control the pandemic.
This service was performed 145 times for 145 patientsThe administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
This service was performed 180 times for 178 patientsThe "Fee Covid-19 Vac 13 Res" service refers to a charge for the 13th dose of the Covid-19 vaccine, typically for individuals requiring additional doses due to specific health conditions. It's crucial to follow your healthcare provider's advice for your health safety.
This service was performed 54 times for 54 patientsThe "Fee covid-19 vac 14 res" refers to a charge for a specific service related to the COVID-19 vaccine. This could be for administering the vaccine or related care. It's crucial to get vaccinated to protect against the virus. The fee ensures quality service.
This service was performed 109 times for 109 patientsThe Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
This service was performed 41 times for 41 patientsThe quadrivalent inactivated influenza vaccine is a shot given to protect against four strains of the flu virus. This 0.5 ml dosage helps your body develop immunity to the virus. It's an important step in preventing flu-related complications.
This service was performed 123 times for 123 patientsThe quadrivalent influenza vaccine is a shot to protect you from four different flu viruses. It's preservative-free and given in a 0.5 ml dose. It helps your body build immunity to the flu, reducing your risk of getting sick.
This service was performed 12 times for 12 patientsThis service provides a FDA-approved COVID-19 test kit for personal use. The test is self-administered and self-collected, meaning you conduct the test yourself. The kit contains all necessary items for one test. Follow the instructions carefully to ensure accurate results.
This service was performed 468 times for 83 patientsReviews for THREE LAKES PHARMACY
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
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 | 1 | 0 | 4 | 2 | 8 | 5 | 9 | 0 | 7 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 0 | 4 | 4 | 8 | 10 | 9 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 0 + 4 + 4 + 8 + 1 + 0 + 9 + 0 + 24 = 53 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 53 = 7 | 7 | ||||||||
The NPI number 1104285907 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 2 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1114390887 | SETH MOE PHARM D. Individual | Pharmacist | 1790 SUPERIOR ST THREE LAKES, WI 54562 (715) 546-3266 |
| 1801506316 | LINDERUD APOTHECARIES LLC Organization | Pharmacy | 1790 SUPERIOR ST THREE LAKES, WI 54562 (715) 546-3266 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1104285907, enumerated in the NPI registry as an "organization" on February 22, 2016
The provider is located at 1790 Superior St Three Lakes, Wi 54562 and the phone number is (715) 546-3266
This medical organization specializes in Pharmacy with taxonomy code 3336C0003X with a focus in Community/Retail Pharmacy
The provider might be accepting Accepts: Health Alliance, Medica, Moda Health Plan, Inc.,. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The most common procedures or services performed by this practitioner are: Adm sarscov2 50mcg/0.25mlbst, Administration of influenza virus vaccine, Fee covid-19 vac 13 res, Fee covid-19 vac 14 res, Influenza vaccine split virus, preservative free, Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage, Influenza vaccine, quadrivalent, preservative free, 0.5 ml dosage and Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count.
This NPI record was last updated on February 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].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.