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AGNESIAN PHARMACY WAUPUN
NPI 1174145031
Pharmacy - Long Term Care Pharmacy in Waupun, WI

Active since May 14, 2020
904 W MAIN ST, WAUPUN, WI 53963(920) 324-8703(920) 324-3476 Get Directions Write a Review

NPPES record last updated: June 7, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 7, 2023, May 14, 2020 (2 updates tracked since 2020).

About Agnesian Pharmacy Waupun NPPES

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

AGNESIAN PHARMACY WAUPUN (NPI 1174145031) is a healthcare organization registered as a long term care pharmacy in Waupun, Wisconsin and active in the NPI registry since May 2020. The organization lists Kimberly Spencer, System Vp Pharmacy Services, as its authorized official.

NPPES Registry Identity

NPI1174145031
Entity TypeOrganization
Primary Taxonomy3336L0003X
Legal Business NameAGNESIAN HEALTHCARE ENTERPRISES LLC
Location Address904 W MAIN STWaupun, WI 53963-1201
Mailing Address145 N Main StFond Du Lac, WI 54935-3423 · (920) 926-6010 · Fax (920) 926-6046
Phone(920) 324-8703
Fax(920) 324-3476
Organization SubpartNo
Authorized OfficialKimberly SpencerSystem Vp Pharmacy Services · (920) 926-6011
Enumeration DateMay 14, 2020
Last NPPES UpdateJune 7, 20232 updates tracked since enumeration
NPPES CertifiedJune 7, 2023
✔ NPI 1174145031 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Long Term Care PharmacySuppliers
Taxonomy Code3336L0003X
Definition
A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.
904 W MAIN ST, Waupun, WI 53963
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Other Names 1

Doing Business AsAgnesian Pharmacy Waupun

Other Identifiers 1

Medicaid33272300WI

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 ›

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.

JANE MARIE KELSEY RPH
Pharmacist
904 W MAIN ST
WAUPUN, WI 53963
Fond Du Lac County (920) 324-3010
AGNESIAN HEALTHCARE INC
Pharmacy (Community/Retail Pharmacy)
904 W MAIN ST
WAUPUN, WI 53963
Fond Du Lac County (920) 324-3010
MRS. KRISTY LOVE BUTEYN PHARMD
Pharmacist
904 W MAIN ST
WAUPUN, WI 53963
Fond Du Lac County (920) 324-3010
JAMES ALFRED VANDERWERFF R.PH
Pharmacist
904 W MAIN ST
WAUPUN, WI 53963
Fond Du Lac County (920) 324-5355
MS. KRISTINE A LYON APNP
Nurse Practitioner (Primary Care)
904 W MAIN ST
WAUPUN, WI 53963
Fond Du Lac County (920) 324-8700

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 Agnesian Healthcare Enterprises LLC's NPI number?

The NPI number for Agnesian Healthcare Enterprises LLC is 1174145031. It was assigned to this organization in the NPPES registry on May 14, 2020. The provider is doing business as Agnesian Pharmacy Waupun.

Where is Agnesian Healthcare Enterprises LLC located?

Agnesian Healthcare Enterprises LLC is located at 904 W Main St, Waupun, WI 53963. The listed phone number is (920) 324-8703.

What is Agnesian Healthcare Enterprises LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Long Term Care Pharmacy, with taxonomy code 3336L0003X.

What insurance does Agnesian Healthcare Enterprises 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 46 other insurers list Agnesian Healthcare Enterprises 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 Agnesian Healthcare Enterprises LLC was last updated on June 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.