ST AGNES HOSPITAL HOME INFUSION
NPI 1114992492
Pharmacy - Home Infusion Therapy Pharmacy in Fond Du Lac, WI

Q: What is the provider's specialty?

The provider's specialty is Pharmacy with taxonomy code 3336H0001X and a focus in Home Infusion Therapy Pharmacy.

Active since February 21, 2006CLIA 52D0397726 · Waiver

430 E DIVISION ST, FOND DU LAC, WI 54935(920) 926-4666 Get Directions Write a Review

NPPES record last updated: June 5, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 5, 2024, Sep 8, 2021 (2 updates tracked since 2021).

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About St Agnes Hospital Home Infusion NPPES

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

ST AGNES HOSPITAL HOME INFUSION (NPI 1114992492) is a healthcare organization registered as a home infusion therapy pharmacy in Fond Du Lac, Wisconsin and active in the NPI registry since February 2006. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Amy Grinnell, Vp-finance, Cfo, as its authorized official.

NPPES Registry Identity

NPI1114992492

Entity TypeOrganization

Primary Taxonomy3336H0001X

Legal Business NameAGNESIAN HEALTHCARE, INC

Location Address430 E DIVISION STFond Du Lac, WI 54935-4560

Mailing Address430 E Division St, Po Box 385Fond Du Lac, WI 54935-4560 · (920) 926-4472 · Fax (920) 926-8885

Phone(920) 926-4666

Organization SubpartNo

Authorized OfficialAmy GrinnellVp-finance, Cfo · (608) 260-3586

Enumeration DateFebruary 21, 2006

Last NPPES UpdateJune 5, 20242 updates tracked since enumeration

NPPES CertifiedJune 5, 2024

✔ NPI 1114992492 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Home Infusion Therapy PharmacySuppliers

Taxonomy Code3336H0001X

Definition

Pharmacy-based, decentralized patient care organization with expertise in USP 797-compliant sterile drug compounding that provides care to patients with acute or chronic conditions generally pertaining to parenteral administration of drugs, biologics and nutritional formulae administered through catheters and/or needles in home and alternate sites. Extensive professional pharmacy services, care coordination, infusion nursing services, supplies and equipment are provided to optimize efficacy and compliance.

Also ListedHome InfusionTaxonomy 251F00000X

430 E DIVISION ST, Fond Du Lac, WI 54935

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Other Names 1

Doing Business AsSt Agnes Hospital Home Infusion

Other Identifiers 1

Medicaid33255500WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Network Health.Insurance ›

CLIA Laboratory Certificates CMS CLIA

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 52D0397726

St Agnes Hosp · Fond Du Lac, WI

Active · expires Aug 31, 2026

CLIA Number52D0397726

Laboratory TypeAncillary Testing Site In Health Care Center

Certificate Effective DateSeptember 1, 2024

Certificate Expiration DateAugust 31, 2026

Laboratory DirectorNidhi Kumar

Laboratory Phone(920) 924-2300

Laboratory LocationSt Agnes Hosp430 E Division St, Fond Du Lac, WI 54935

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

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.

MARY LAUSCH ARRIGONI CRNA

Nurse Anesthetist, Certified Registered