Wisconsin CVS Pharmacy LLC
NPI 1104848704ActiveOrganization· Pharmacy· Oak Creek, WI
Pharmacy in Oak Creek, Wisconsin, registered in NPPES in July 2006. The authorized official on file is Susan Colbert, Sr. Director, Payer Relations. Medicare paid $37,400 for services to 165 patients in 2024.
Overview
| NPI | 1104848704 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 24, 2006 |
| Last updated in NPPES | Dec 13, 2016 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | — | — |
| Durable Medical Equipment & Medical Supplies | 332B00000X | — | — |
| Pharmacy, Community/Retail Pharmacy | 3336C0003X | 8463042 | WI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Pharmacy (WI) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 165 |
|---|---|
| Services billed | 506 across 10 procedure codes |
| Paid by Medicare | $37,400 |
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