Wisconsin Cvs Pharmacy LLC
NPI 1174564041 · Pharmacy · Kenosha, WI
Enrolled with Medicare as Dme Supplier - Pharmacy · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Wisconsin Cvs Pharmacy LLC is a Pharmacy organization in Kenosha, WI (NPI 1174564041).
Provider details
- NPI number
- 1174564041
- Entity type
- Organization
- Primary specialty
- PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Cristiana Mauricio, Manager Pharmacy Enrollments(401) 770-2937
Specialties & taxonomies
Suppliers
- Community/Retail Pharmacy3336C0003X
Suppliers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
20 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
418 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. 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.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Admn Sarscov2 Vacc 1 Dose90480 | 203 | $40 |
| Administration of Influenza Virus VaccineG0008 | 200 | $30 |
| Administration of Pneumococcal VaccineG0009 | 15 | $29 |
Typical Medicare-allowed amounts for these services range $29–$40 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Cvs Pharmacy
Registry dates
- Enumerated
- 2006-06-09
- Last updated
- 2008-02-27
Frequently asked questions
- What is Wisconsin Cvs Pharmacy LLC's NPI number?
- Wisconsin Cvs Pharmacy LLC's National Provider Identifier (NPI) is 1174564041, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Wisconsin Cvs Pharmacy LLC?
- Wisconsin Cvs Pharmacy LLC is classified in the NPPES registry as Pharmacy (Suppliers).
- Where is Wisconsin Cvs Pharmacy LLC located?
- Wisconsin Cvs Pharmacy LLC's practice location on file with NPPES is 3726 22nd Ave, Kenosha, WI 53140-5300.
- What is Wisconsin Cvs Pharmacy LLC's phone number?
- The practice phone number listed in the NPPES registry for Wisconsin Cvs Pharmacy LLC is (262) 654-6545.
- Does Wisconsin Cvs Pharmacy LLC accept Medicare?
- Wisconsin Cvs Pharmacy LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Wisconsin Cvs Pharmacy LLC?
- The authorized official listed on Wisconsin Cvs Pharmacy LLC's NPPES record is Cristiana Mauricio, Manager Pharmacy Enrollments. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Wisconsin Cvs Pharmacy LLC's NPI active?
- Yes — Wisconsin Cvs Pharmacy LLC's NPI (1174564041) is active in the NPPES registry as of the last update on 2008-02-27.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.