La Clinica de Los Campesinos, Inc
NPI 1174322846ActiveOrganization· Pharmacy· Wautoma, WI
Pharmacy in Wautoma, Wisconsin, registered in NPPES in March 2025. The authorized official on file is Kellen Dorff, Director Of Pharmacy. Enrolled in Medicare as part b supplier - pharmacy.
Overview
| NPI | 1174322846 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 13, 2025 |
| Last updated in NPPES | Jun 17, 2025 |
| Certified by provider | Jun 17, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | — | — |
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 Part B Supplier - Pharmacy (WI) |
|---|
Other Pharmacy providers in Wautoma
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