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

Get Directions Write a Review

  • 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.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

GARY DONALDSON

Authorized Official Title
PRESIDENT
Authorized Official Phone
(715) 276-3646

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
5133056OTHER (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

Reviews for NICOLET PHARMACY INC-340B 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 NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1114290707, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 53. The final step is to find the difference between that total and the next multiple of ten (60 - 53 = 7).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
1
Doubled → 2
Pos 4
4
Unchanged
Pos 5
2
Doubled → 4
Pos 6
9
Unchanged
Pos 7
0
Doubled → 0
Pos 8
7
Unchanged
Pos 9
0
Doubled → 0
Check
7
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 2 → 4 0 → 0 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 2 + 4 + 4 + 9 + 0 + 7 + 0 + 24 = 53

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 53 is 60. The difference is the calculated check digit.

60 - 53 = 7
This NPI is valid
The calculated check digit is 7, which matches the last digit of 1114290707.

Other Providers at the Same Location


The following 5 providers are registered at the same or a nearby location.

Chiropractor
15481 COMMERCIAL RD
LAKEWOOD, WI 54138
Pharmacist
15481 COMMERCIAL RD
LAKEWOOD, WI 54138
Pharmacist
15481 COMMERCIAL RD
LAKEWOOD, WI 54138
Pharmacy (Community/Retail Pharmacy)
15481 COMMERCIAL RD
LAKEWOOD, WI 54138
Pharmacist
15481 COMMERCIAL RD
LAKEWOOD, WI 54138

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1114290707, enumerated 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.

Pharmacy with taxonomy code 3336C0003X and 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 verify.