ST AGNES HOSPITAL HOME INFUSION
NPI 1114992492
Pharmacy - Home Infusion Therapy Pharmacy in Fond Du Lac, WI
NPI Status: Active since February 21, 2006
Contact Information
430 E DIVISION ST
FOND DU LAC, WI
ZIP 54935
Phone: (920) 926-4666
- Organization
- Pharmacy
- Home Infusion Therapy Pharmacy
- Accepts Insurance
- CLIA Number: 52D0397726
- CLIA Cert. Type: Ancillary Testing Site in Health Care Center
- CLIA Exp. Date: 08-31-2026
About ST AGNES HOSPITAL HOME INFUSION
This page provides the complete NPI Profile along with additional information for St Agnes Hospital Home Infusion, a provider established in Fond Du Lac, Wisconsin operating as a Pharmacy, focusing in home infusion therapy pharmacy . The healthcare provider is registered in the NPI registry with number 1114992492 assigned on February 2006. The practitioner's primary taxonomy code is 3336H0001X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's is doing business as St Agnes Hospital Home Infusion. The authorized official of this NPI record is Amy Grinnell (Vp-finance, Cfo)
- NPI
- 1114992492
- Provider Legal Name
- AGNESIAN HEALTHCARE, INC
- Other Organization Name
- ST AGNES HOSPITAL HOME INFUSION
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 430 E DIVISION ST FOND DU LAC, WI 54935
- Location Phone
- (920) 926-4666
- Mailing Address
- 430 E DIVISION ST PO BOX 385 FOND DU LAC, WI 54935
- Mailing Phone
- (920) 926-4472
- Mailing Fax
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 02-21-2006
- Last Update Date
- 06-05-2024
- Code Navigator
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 Home Infusion Therapy Pharmacy
- Taxonomy Code
- 3336H0001X
- Type
- Suppliers
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 251F00000X | Agencies | Home Infusion |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
- Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
- Anthem Silver Preferred/Broad 4000 ($0 PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Silver Preferred/Broad 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Silver Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Prestige Bronze $0 Medical Deductible - HMO
- Prestige Bronze $0 Medical Deductible + Dental + Vision - HMO
- Prestige Bronze $0 Medical Deductible + Dental +Vision - HMO
- Prestige Bronze Essential + 3 Free PCP Visits - HMO
- Prestige Bronze Essential + Dental + Vision + 3 Free PCP Visits - HMO
- Prestige Bronze Plus - HMO
- Prestige Gold - HMO
- Prestige Gold 50 + 1 Free PCP Visit - HMO
- Prestige Gold 50 + Dental + Vision + 1 Free PCP Visit - HMO
- Prestige Gold 50 + Dental + Vision+ 1 Free PCP Visit - HMO
- Prestige Gold Essential + 3Free PCP Visits - HMO
- Prestige Gold Essential + Dental + Vision + 3 Free PCP Visits - HMO
- Prestige Silver - HMO
- Prestige Silver Essential + 3 Free PCP Visits - HMO
- Prestige Silver Essential + Dental + Vision + 3 Free PCP Visits - HMO
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.
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 |
|---|---|---|---|
| 33255500 | MEDICAID (05) | WI |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 52D0397726
- Facility Type
- Ancillary Testing Site in Health Care Center
- Certificate Effective Date
- September 01, 2024
- Certificate Expiration Date
- August 31, 2026
- Laboratory Director
- NIDHI KUMAR
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to St Agnes Hospital Home Infusion to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for ST AGNES HOSPITAL HOME INFUSION
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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 1114992492, we treat the final digit (2) 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 68. The final step is to find the difference between that total and the next multiple of ten (70 - 68 = 2).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 68 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
FOND DU LAC, WI 54935
FOND DU LAC, WI 54935
FOND DU LAC, WI 54935
FOND DU LAC, WI 54935
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1114992492, enumerated as an "organization" on February 21, 2006.
The provider is located at 430 E DIVISION ST FOND DU LAC, WI 54935 and the phone number is (920) 926-4666.
Pharmacy with taxonomy code 3336H0001X and a focus in Home Infusion Therapy Pharmacy.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Network Health,. Please consult your insurance carrier or call the provider to verify.
