AGNESIAN HEALTHCARE INC
NPI 1104891746
Pharmacy - Community/Retail Pharmacy in Fond Du Lac, WI

Q: What is Agnesian Healthcare Inc's NPI number?

The NPI number for Agnesian Healthcare Inc is 1104891746. It was assigned to this organization in the NPPES registry on February 17, 2006. The provider is doing business as SSM Health Pharmacy.

Q: What is Agnesian Healthcare Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Active since February 17, 2006

145 N MAIN ST, FOND DU LAC, WI 54935(920) 926-4660(920) 922-5011 Get Directions Write a Review

NPPES record last updated: July 23, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 6, 2025, Dec 17, 2024, Dec 15, 2024 and 1 more (4 updates tracked since 2016).

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About Agnesian Healthcare Inc NPPES

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

AGNESIAN HEALTHCARE INC (NPI 1104891746), doing business as Ssm Health Pharmacy, is a healthcare organization registered as a community/retail pharmacy in Fond Du Lac, Wisconsin and active in the NPI registry since February 2006. The organization lists Amy Jo Grinnell, Finance Vice President Wi Region, as its authorized official.

NPPES Registry Identity

NPI1104891746

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameAGNESIAN HEALTHCARE INC

Location Address145 N MAIN STFond Du Lac, WI 54935-3423

Mailing Address145 N Main StFond Du Lac, WI 54935-3423 · (920) 921-4660 · Fax (920) 922-5011

Phone(920) 926-4660

Fax(920) 922-5011

Organization SubpartNo

Authorized OfficialAmy Jo GrinnellFinance Vice President Wi Region · (608) 260-3586

Enumeration DateFebruary 17, 2006

Last NPPES UpdateJuly 23, 20254 updates tracked since enumeration

NPPES CertifiedJuly 23, 2025

✔ NPI 1104891746 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers

Taxonomy Code3336C0003X

Definition

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.

145 N MAIN ST, Fond Du Lac, WI 54935

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Other Names 1

Doing Business AsSsm Health Pharmacy

Other Identifiers 3

Medicaid100307261WI

Other2109968Pk

Medicaid33259200WI

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 ›

Areas of Expertise CMS Part B claims 2

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.

24 services23 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.

22 services22 patients

Medical Equipment Supplier Medicare DMEPOS 6

Medicare supplier enrollment and the product categories Agnesian Pharmacy carries, from the Medicare DMEPOS supplier directory.

Agnesian Pharmacy

DMEPOS supplier · Fond Du Lac, WIOperated by Agnesian Healthcare Enterprises LLC

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Does not accept Medicare assignment

Agnesian Pharmacy has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20606021

Medicare Participant SinceMarch 15, 2002

Supplier Location145 N Main StFond Du Lac, WI 54935

Phone(920) 926-4660

Supplier Specialties

Pharmacy

Medicare Product Categories

Epoetin

Epoetin is a man-made version of human erythropoietin (EPO)

Immunosuppressive Drugs

Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant

Infusion Drugs

Oral Anticancer Drugs

FDA anticancer drugs

Oral Antiemetic Drugs

FDA antiemetic drugs

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

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 20

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

MARK S KERMGARD MD

Emergency Medicine