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THEDACARE APOTHECARY-SHAWANO
NPI 1306516604
Pharmacy - Community/Retail Pharmacy in Shawano, WI

Active since September 17, 2021CLIA 52D2330430 · Waiver
100 COUNTY ROAD B, SHAWANO, WI 54166(715) 526-7300(920) 993-5031 Get Directions Write a Review

NPPES record last updated: January 3, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 3, 2024, Apr 5, 2022, Oct 14, 2021 and 1 more (4 updates tracked since 2021).

About Thedacare Apothecary-shawano NPPES

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

THEDACARE APOTHECARY-SHAWANO (NPI 1306516604) is a healthcare organization registered as a community/retail pharmacy in Shawano, Wisconsin and active in the NPI registry since September 2021. The organization holds a CLIA Waiver certificate valid through September 15, 2027 and lists William Flett, Cfo, as its authorized official.

NPPES Registry Identity

NPI1306516604
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameTHEDACARE MEDICAL CENTER - SHAWANO, INC.
Location Address100 COUNTY ROAD BShawano, WI 54166-7072
Mailing Address100 County Road BShawano, WI 54166-7072 · (715) 526-7300 · Fax (920) 993-5031
Phone(715) 526-7300
Fax(920) 993-5031
Organization SubpartNo
Authorized OfficialWilliam FlettCfo · (920) 454-4013
Enumeration DateSeptember 17, 2021
Last NPPES UpdateJanuary 3, 20244 updates tracked since enumeration
NPPES CertifiedJanuary 3, 2024
✔ NPI 1306516604 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.
100 COUNTY ROAD B, Shawano, WI 54166
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Other Names 1

Doing Business AsThedacare Apothecary-shawano

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Anthem Blue Cross and Blue Shield, Antidote Health Plan of Arizona, Inc. and more.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 52D2330430

Thedacare At Work - Shawano · Shawano, WI
Active · expires Sep 15, 2027
CLIA Number52D2330430
Laboratory TypeOccupational Health
Certificate Effective DateSeptember 16, 2025
Certificate Expiration DateSeptember 15, 2027
Laboratory DirectorQuinn E. Strenn
Laboratory Phone(715) 524-1510
Laboratory LocationThedacare At Work - Shawano100 County Road B, Shawano, WI 54166
CLIA data matches this NPI record on: Address
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.

SHOPKO STORES OPERATING CO., LLC
Pharmacy (Community/Retail Pharmacy)
100 COUNTY ROAD B
SHAWANO, WI 54166
Shawano County (920) 429-4726
MR. DAVID A KLOSS M.D.
Surgery
100 COUNTY ROAD B
SHAWANO, WI 54166
Shawano County (715) 524-2161
DR. MINDY MARIA FRIMODIG DO
Family Medicine
100 COUNTY ROAD B
SHAWANO, WI 54166
Shawano County (715) 524-2161
CAROLYN ANNE FLOOD OTR/L
Occupational Therapist
100 COUNTY ROAD B
SHAWANO, WI 54166
Shawano County (715) 526-7370
WILL GILLIS PHARMD
Pharmacist
100 COUNTY ROAD B
SHAWANO, WI 54166
Shawano County (715) 526-3456
RACHEL NAULT PHARMD
Pharmacist
100 COUNTY ROAD B
SHAWANO, WI 54166
Shawano County (715) 524-2161
ALEXIS VANDEHEY
Pharmacist
100 COUNTY ROAD B
SHAWANO, WI 54166
Shawano County (920) 203-0630
JENNA J MULDER
Physician Assistant
100 COUNTY ROAD B
SHAWANO, WI 54166
Shawano County (715) 526-2111

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 Thedacare Medical Center - Shawano, Inc.'s NPI number?

The NPI number for Thedacare Medical Center - Shawano, Inc. is 1306516604. It was assigned to this organization in the NPPES registry on September 17, 2021. The provider is doing business as Thedacare Apothecary-Shawano.

Where is Thedacare Medical Center - Shawano, Inc. located?

Thedacare Medical Center - Shawano, Inc. is located at 100 County Road B, Shawano, WI 54166. The listed phone number is (715) 526-7300.

What is Thedacare Medical Center - Shawano, Inc.'s specialty?

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

Does Thedacare Medical Center - Shawano, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 52D2330430) is associated with this NPI, valid through September 15, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Thedacare Medical Center - Shawano, Inc. accept?

Health plans from Alliant Health Plans, Inc., Anthem Blue Cross and Blue Shield, Antidote Health Plan of Arizona, Inc., Antidote Health Plan of Ohio, Inc. and AvMed and 33 other insurers list Thedacare Medical Center - Shawano, Inc. 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 Thedacare Medical Center - Shawano, Inc. was last updated on January 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.