Gundersen Long Term Care Pharmacy

LBN: Gundersen Clinic Ltd
Gundersen Long Term Care Pharmacy is an health care organization with primary practice located at 505 King St Ste 154 , La Crosse WI 54601-4062. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Long Term Care Pharmacy is the primary health care specialty. Gundersen Clinic Ltd can be contacted via phone (608) 782-4448, or through Carrell, Loren via phone (608) 775-6369.

Contact Information

Primary practice address
505 King St Ste 154 La Crosse WI 54601-4062
Phone: (608) 782-4448
Fax: (608) 782-4449
Website:
Map and Directions
Authorized official contact:
Name: Carrell, Loren
Phone: (608) 775-6369

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Long Term Care Pharmacy 3336L0003X 9420-42 Wisconsin

Profile Details

NPI number 1699225474
LBN Legal business name Gundersen Clinic Ltd
DBA Doing business as Gundersen Long Term Care Pharmacy
Authorized official Carrell, Loren
Entity Organization
Organization subpart 1 Yes
Enumeration date Oct 5th, 2016
Last updated Nov 8th, 2020 - 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 1699225474 NPPES
Wisconsin MEDICAID 100064708
Wisconsin Other 2163999

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