OrganizationActive
Nicolet Pharmacy, Inc.
NPI 1114290707 · Community/Retail Pharmacy · Lakewood, WI
Nicolet Pharmacy, Inc. is a Community/Retail Pharmacy organization in Lakewood, WI (NPI 1114290707).
Provider details
- NPI number
- 1114290707
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Gary Donaldson, President(715) 276-3646
- License
- 757642 (WI)
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(80/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES 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
Lakewood, WI 54138-9677
Phone: (715) 276-3646
Fax: (715) 276-9568
Street-level locationGet directions
Mailing address
15481 Commercial Rd
Lakewood, WI 54138-9677
Other names (DBA / former)
- Doing business as
- Nicolet Pharmacy Inc-340b Pharmacy
Registry dates
- Enumerated
- 2012-02-14
- Last updated
- 2012-02-14
Frequently asked questions
- What is Nicolet Pharmacy, Inc.'s NPI number?
- Nicolet Pharmacy, Inc.'s National Provider Identifier (NPI) is 1114290707, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Nicolet Pharmacy, Inc.?
- Nicolet Pharmacy, Inc. is classified in the NPPES registry as Community/Retail Pharmacy (Suppliers).
- Where is Nicolet Pharmacy, Inc. located?
- Nicolet Pharmacy, Inc.'s practice location on file with NPPES is 15481 Commercial Rd, Lakewood, WI 54138-9677.
- What is Nicolet Pharmacy, Inc.'s phone number?
- The practice phone number listed in the NPPES registry for Nicolet Pharmacy, Inc. is (715) 276-3646.
- Who is the authorized official for Nicolet Pharmacy, Inc.?
- The authorized official listed on Nicolet Pharmacy, Inc.'s NPPES record is Gary Donaldson, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Nicolet Pharmacy, Inc.'s NPI active?
- Yes — Nicolet Pharmacy, Inc.'s NPI (1114290707) is active in the NPPES registry as of the last update on 2012-02-14.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.