| NPI | 1104891746 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2006-02-17 |
| Last Updated | 2025-07-23 |
| Authorized Official | Amy Grinnell Finance Vice President WI Region Phone: 6082603586 |
| Mailing Address | 145 N Main St Fond Du Lac, WI 54935-3423 United States Phone: (920) 921-4660 | Fax: (920) 922-5011 📍 View Map |
| Primary Practice Address | 145 N Main St Fond Du Lac, WI 54935-3423 United States Phone: (920) 926-4660 | Fax: (920) 922-5011 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | WI | 100307261 | — |
| Other (non-Medicare) | — | 2109968 | PK |
| MEDICAID | WI | 33259200 | — |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 3336C0003X – Pharmacy, Community/Retail Pharmacy | — | — |
Use our free NPI Lookup tool to find any healthcare provider in the NPPES registry. Search NPI →
About NPI 1104891746
Agnesian Healthcare Inc is an organization registered in the CMS NPPES NPI Registry with NPI number 1104891746. The primary specialty listed is Pharmacy, Community/Retail Pharmacy. The organization is located in Fond Du Lac, WI. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-02-17. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1104891746?
NPI 1104891746 belongs to Agnesian Healthcare Inc, a Pharmacy, Community/Retail Pharmacy in Fond Du Lac, WI. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1104891746 active?
The current status of NPI 1104891746 in the NPPES registry is Active. The record was last updated on 2025-07-23.
What specialty is NPI 1104891746?
NPI 1104891746 is classified under the taxonomy Pharmacy, Community/Retail Pharmacy. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1104891746?
You can verify NPI 1104891746 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1104891746?
The primary practice address on file for NPI 1104891746 is 145 N Main St, Fond Du Lac, WI 54935-3423. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1104891746 issued?
NPI 1104891746 was first issued (enumerated) on 2006-02-17. The NPPES record was last updated on 2025-07-23.
Practice Location Map
Agnesian Healthcare Inc is located at 145 N Main St, Fond Du Lac, WI. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Agnesian Healthcare Inc. All records sourced from the CMS NPPES registry.