OrganizationActive
Nicolet Pharmacy Long Term Care
NPI 1063302990 · Long Term Care Pharmacy · Lakewood, WI
Nicolet Pharmacy Long Term Care is a Long Term Care Pharmacy organization in Lakewood, WI (NPI 1063302990).
Provider details
- NPI number
- 1063302990
- Entity type
- Organization
- Primary specialty
- Long Term Care PharmacySuppliers
- Parent organization
- Nicolet Pharmacy Inc
- Organization subpart
- Yes
- Authorized official
- Amy Donaldson, President(715) 276-3646
Specialties & taxonomies
Suppliers
Profile Score
Established profile(54/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
15481 Commercial Rd Ste a
Lakewood, WI 54138-9677
Phone: (715) 276-3646
Fax: (715) 276-9568
Street-level locationGet directions
Mailing address
15481 Commercial Rd Ste a
Lakewood, WI 54138-9677
Registry dates
- Enumerated
- 2025-07-03
- Last updated
- 2025-07-03
- Certified
- 2025-07-03
Frequently asked questions
- What is Nicolet Pharmacy Long Term Care's NPI number?
- Nicolet Pharmacy Long Term Care's National Provider Identifier (NPI) is 1063302990, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Nicolet Pharmacy Long Term Care?
- Nicolet Pharmacy Long Term Care is classified in the NPPES registry as Long Term Care Pharmacy (Suppliers).
- Where is Nicolet Pharmacy Long Term Care located?
- Nicolet Pharmacy Long Term Care's practice location on file with NPPES is 15481 Commercial Rd Ste a, Lakewood, WI 54138-9677.
- What is Nicolet Pharmacy Long Term Care's phone number?
- The practice phone number listed in the NPPES registry for Nicolet Pharmacy Long Term Care is (715) 276-3646.
- Who is the authorized official for Nicolet Pharmacy Long Term Care?
- The authorized official listed on Nicolet Pharmacy Long Term Care's NPPES record is Amy Donaldson, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Nicolet Pharmacy Long Term Care's NPI active?
- Yes — Nicolet Pharmacy Long Term Care's NPI (1063302990) is active in the NPPES registry as of the last update on 2025-07-03.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.