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CVS PHARMACY #16256
NPI 1003838608
Pharmacy in Fond Du Lac, WI

Active since July 24, 2006CLIA Certified · 4 labs
485 N ROLLING MEADOWS DR, FOND DU LAC, WI 54937(920) 921-6759(920) 266-4298 Get Directions Write a Review

NPPES record last updated: December 5, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Cvs Pharmacy #16256 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CVS PHARMACY #16256 (NPI 1003838608) is a healthcare organization registered as a pharmacy in Fond Du Lac, Wisconsin and active in the NPI registry since July 2006. The organization holds 4 active CLIA laboratory certificates and lists Susan Colbert, Sr. Director, Payer Relations, as its authorized official.

NPPES Registry Identity

NPI1003838608
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWISCONSIN CVS PHARMACY LLC
Location Address485 N ROLLING MEADOWS DRFond Du Lac, WI 54937-9784
Mailing Address1 Cvs Dr, Box 1075Woonsocket, RI 02895-6146 · (401) 765-1500
Phone(920) 921-6759
Fax(920) 266-4298
Organization SubpartNo
Authorized OfficialSusan ColbertSr. Director, Payer Relations · (401) 770-2751
Enumeration DateJuly 24, 2006
Last NPPES UpdateDecember 5, 2016
✔ NPI 1003838608 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
Definition
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X · License 8558042 (WI)
485 N ROLLING MEADOWS DR, Fond Du Lac, WI 54937
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Other Names 1

Doing Business AsCvs Pharmacy #16256

Other Identifiers 2

Medicare NSC5742910059
Other2110844Pk

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA 5

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 16D2187203

Iowa CVS Pharmacy, LLC Dba Cvs/Pharmacy # 04816 · Council Bluffs, IA
Active · expires Jun 25, 2028
CLIA Number16D2187203
Laboratory TypePharmacy
Certificate Effective DateJune 26, 2026
Certificate Expiration DateJune 25, 2028
Laboratory DirectorKierstyn Evers
Laboratory Phone(401) 765-1500
Laboratory LocationIowa CVS Pharmacy, LLC Dba Cvs/Pharmacy # 04816545 W Washington Street, Council Bluffs, IA 51503
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 51D2262288

West Virginia CVS Pharmacy, LLC Dba Cvs/Pharmacy #02148 · Charleston, WV
Active · expires Jun 12, 2028
CLIA Number51D2262288
Laboratory TypePharmacy
Certificate Effective DateJune 13, 2026
Certificate Expiration DateJune 12, 2028
Laboratory DirectorChristopher Schuler
Laboratory Phone(401) 765-1500
Laboratory LocationWest Virginia CVS Pharmacy, LLC Dba Cvs/Pharmacy #02148885 Oakwood Rd, Charleston, WV 25314
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 46D2280197

CVS Pharmacy #10308 · Herriman, UT
Active · expires Apr 13, 2027
CLIA Number46D2280197
Laboratory TypePharmacy
Certificate Effective DateApril 14, 2025
Certificate Expiration DateApril 13, 2027
Laboratory DirectorDerek Roylance
Laboratory Phone(401) 765-1500
Laboratory LocationCVS Pharmacy #103084968 West 13400 South, Herriman, UT 84096
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 16D2220112

Iowa CVS Pharmacy, LLC Dba Cvs/Pharmacy #10329 · Des Moines, IA
Active · expires Apr 8, 2027
CLIA Number16D2220112
Laboratory TypePharmacy
Certificate Effective DateApril 9, 2025
Certificate Expiration DateApril 8, 2027
Laboratory DirectorCheyenne Mckeehan
Laboratory Phone(401) 765-1500
Laboratory LocationIowa CVS Pharmacy, LLC Dba Cvs/Pharmacy #103292303 Merle Hay Road, Des Moines, IA 50310
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 46D2189450

CVS Pharmacy #10423 · Salt Lake City, UT
Expired · Jul 30, 2026
CLIA Number46D2189450
Laboratory TypePharmacy
Certificate Effective DateJuly 31, 2024
Certificate Expiration DateJuly 30, 2026
Laboratory DirectorJustin Benson
Laboratory Phone(401) 765-1500
Laboratory LocationCVS Pharmacy #104231269 E 2100 S, Salt Lake City, UT 84106
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The 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.
160 services159 patients
Influenza vaccine, inactivated 90653
The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.
80 services80 patients
Influenza vaccine split virus, preservative free 90662
The 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.
68 services68 patients

Medical Equipment Supplier Medicare DMEPOS 19

Medicare supplier enrollment and the product categories Wisconsin CVS Pharmacy LLC carries, from the Medicare DMEPOS supplier directory.

Wisconsin CVS Pharmacy LLC

DMEPOS supplier · Fond Du Lac, WI
✔

Accepts Medicare assignment

Wisconsin CVS Pharmacy LLC agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20325389
Medicare Participant SinceJanuary 1, 2023
Supplier Location485 N Rolling Meadows DrFond Du Lac, WI 54937
Phone(920) 921-6759
Supplier Specialties
Pharmacy

Medicare Product Categories

Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Infusion Drugs
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Commodes, Urinals, Bedpans
Raised toilets, Drop-arm commodes, Folding commodes, Plastic urinals, Plastic bedpans, Disposable urinals
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. JON DANIEL HERDRICH R.PH.
Pharmacist
485 N ROLLING MEADOWS DR, T0808
FOND DU LAC, WI 54937
Fond Du Lac County (920) 921-6759
DR. DAVID MOUNIR NASSIF MORCOS PHARMD
Pharmacist
485 N ROLLING MEADOWS DR
FOND DU LAC, WI 54937
Fond Du Lac County (920) 921-6759
DR. ERIN LEININGER PHARMD
Pharmacist
485 N ROLLING MEADOWS DR
FOND DU LAC, WI 54937
Fond Du Lac County (920) 921-6759
DR. GINA MICHELE FRAZIER PHARM D
Pharmacist
485 N ROLLING MEADOWS DR
FOND DU LAC, WI 54937
Fond Du Lac County (920) 921-6759
CHRISTOPHER CASEY
Pharmacist
485 N ROLLING MEADOWS DR, T-0808
FOND DU LAC, WI 54937
Fond Du Lac County (920) 921-6759

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wisconsin CVS Pharmacy LLC's NPI number?

The NPI number for Wisconsin CVS Pharmacy LLC is 1003838608. It was assigned to this organization in the NPPES registry on July 24, 2006. The provider is doing business as CVS Pharmacy #16256.

Where is Wisconsin CVS Pharmacy LLC located?

Wisconsin CVS Pharmacy LLC is located at 485 N Rolling Meadows Dr, Fond Du Lac, WI 54937. The listed phone number is (920) 921-6759.

What is Wisconsin CVS Pharmacy LLC's specialty?

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

Does Wisconsin CVS Pharmacy LLC accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Wisconsin CVS Pharmacy LLC accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Wisconsin CVS Pharmacy LLC hold CLIA laboratory certificates?

Yes. 4 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Wisconsin CVS Pharmacy LLC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 34 other insurers list Wisconsin CVS Pharmacy LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Wisconsin CVS Pharmacy LLC was last updated on December 5, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.