Wisconsin CVS Pharmacy LLC
NPI 1174564041ActiveOrganization· Pharmacy· Kenosha, WI
Pharmacy in Kenosha, Wisconsin, registered in NPPES in June 2006. The authorized official on file is Cristiana Mauricio, Manager Pharmacy Enrollments. Medicare paid $64,585 for services to 244 patients in 2024.
Overview
| NPI | 1174564041 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 9, 2006 |
| Last updated in NPPES | Feb 27, 2008 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | — | — |
| Pharmacy, Community/Retail Pharmacy | 3336C0003X | — | — |
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 | 244 |
|---|---|
| Services billed | 836 across 13 procedure codes |
| Paid by Medicare | $64,585 |
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