NICOLET PHARMACY INC-340B PHARMACY
NPI 1114290707
Pharmacy - Community/Retail Pharmacy in Lakewood, WI
NPI Status: Active since February 14, 2012
Contact Information
15481 COMMERCIAL RD
LAKEWOOD, WI
ZIP 54138
Phone: (715) 276-3646
Fax: (715) 276-9568
- Organization
- Pharmacy
- Community/Retail Pharmacy
- Medicare Supplier
- Accepts Medicare Approved Payment
About NICOLET PHARMACY INC-340B PHARMACY
This page provides the complete NPI Profile along with additional information for Nicolet Pharmacy Inc-340b Pharmacy, a provider established in Lakewood, Wisconsin operating as a Pharmacy, focusing in community/retail pharmacy . The healthcare provider is registered in the NPI registry with number 1114290707 assigned on February 2012. The practitioner's primary taxonomy code is 3336C0003X with license number 757642 (WI). The provider is registered as an organization and their NPI record was last updated 14 years ago. The provider's is doing business as Nicolet Pharmacy Inc-340b Pharmacy. The authorized official of this NPI record is Gary Donaldson (President)
- NPI
- 1114290707
- Provider Legal Name
- NICOLET PHARMACY, INC.
- Other Organization Name
- NICOLET PHARMACY INC-340B PHARMACY
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 15481 COMMERCIAL RD LAKEWOOD, WI 54138
- Location Phone
- (715) 276-3646
- Location Fax
- (715) 276-9568
- Mailing Address
- 15481 COMMERCIAL RD LAKEWOOD, WI 54138
- Mailing Phone
- (715) 276-3646
- Mailing Fax
- (715) 276-9568
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 02-14-2012
- Last Update Date
- 02-14-2012
- Code Navigator
Nicolet Pharmacy Inc-340b Pharmacy is a medicare supplier with PTAN 20618195 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Blood Glucose Monitors/Supplies (Non-Mail Order) or Insulin Infusion Pumps and/or Supplies or Support Surfaces: Pressure Reducing Beds/Mats/Pads or (TENS) Transcutaneous Electrical Nerve Stimulators and/or Supplies or Canes and/or Crutches or Walkers or Wheelchairs (Standard Manual) or Wheelchairs (Standard Manual Related Accessories) or Wheelchair Seating/Cushions or Ostomy Supplies or Tracheotomy Supplies or Urological Supplies or Nebulizer Equipment and/or Supplies or Surgical Dressings or Diabetic Shoes and Inserts or Diabetic Shoes/Inserts - Custom.
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.
- 757642
- 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.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
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 |
|---|---|---|---|
| 5133056 | OTHER (01) | NCPDP PROVIDER IDENTIFICATION NUMBER |
Medical Equipment Supplier
The provider carries the following medical supplies product categories:
- PTAN
- 20618195
- Accepts Medicare Assignment
- YES
- Specialities List
- Pharmacy.
- Competitive Bidding
- NO
Supplies List
- Blood Glucose Monitors/Supplies (Non-Mail Order) - Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
- Insulin Infusion Pumps and/or Supplies - Disposable Insulin Delivery System, Mechanical insulin infusion pumps, Needle type infusion sets, Cannula type infusion sets
- Support Surfaces: Pressure Reducing Beds/Mats/Pads - Group 1 – Alternating pressure pad, Air/Water/Dry pressure pad or pressure mattress. Group 2 - Pressure reducing powered air mattresses, Powered air flotation bed, non-powered pressure reducing mattress Group 3 – Air fluidized bed
- (TENS) Transcutaneous Electrical Nerve Stimulators and/or Supplies - Transcutaneous Electrical Nerve Stimulation (TENS) for the relief of acute post-operative pain
- Canes and/or Crutches - Standard Canes, Quad Canes, Offset Canes, Standard Crutches, Forearm Crutches
- Walkers - Standard Walkers, Wheeled Walkers, Folding Walker
- Wheelchairs (Standard Manual) - Standard wheelchairs, transport wheelchairs, heavy duty wheelchairs
- Wheelchairs (Standard Manual Related Accessories) - Accessories for standard wheelchairs, transport wheelchairs, heavy duty wheelchairs
- Wheelchair Seating/Cushions - Wheelchair seat cushions, Wheelchair bank cushions, Wheelchair padded armrests
- Ostomy Supplies - Pouches, Paste, Powder, Barrier wipes
- Tracheotomy Supplies - Tracheostomy care kits
- Urological Supplies - Catheters, Urinary collection devices
- Nebulizer Equipment and/or Supplies - Nebulizers, Atomizers, Filters
- Surgical Dressings - Gauze, Elastic bandages, Adhesive tape
- Diabetic Shoes and Inserts - Shoes, Socks, Insoles
- Diabetic Shoes/Inserts - Custom - Custom fabricated shoes, socks, & insoles
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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 | 1 | 1 | 4 | 2 | 9 | 0 | 7 | 0 | 7 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 2 | 4 | 4 | 9 | 0 | 7 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 2 + 4 + 4 + 9 + 0 + 7 + 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 1114290707 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 5 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1629000120 | NOBLES CHIROPRACTIC WELLNESS CENTER, LLC Organization | Chiropractor | 15481 COMMERCIAL RD LAKEWOOD, WI 54138 (715) 276-3401 |
| 1326221284 | MR. MICHAEL W WIXOM RPH Individual | Pharmacist | 15481 COMMERCIAL RD LAKEWOOD, WI 54138 (715) 276-3646 |
| 1841473717 | MR. GARY A DONALDSON RPH Individual | Pharmacist | 15481 COMMERCIAL RD LAKEWOOD, WI 54138 (715) 276-3646 |
| 1851321566 | NICOLET PHARMACY INC Organization | Pharmacy (Community/Retail Pharmacy) | 15481 COMMERCIAL RD LAKEWOOD, WI 54138 (715) 276-3646 |
| 1871224261 | DEREK LOCH RPH Individual | Pharmacist | 15481 COMMERCIAL RD LAKEWOOD, WI 54138 (715) 276-3646 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1114290707, enumerated in the NPI registry as an "organization" on February 14, 2012
The provider is located at 15481 Commercial Rd Lakewood, Wi 54138 and the phone number is (715) 276-3646
This medical organization specializes in Pharmacy with taxonomy code 3336C0003X with a focus in Community/Retail Pharmacy
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
This NPI record was last updated on February 14, 2012. 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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