National Provider Identifier Database

DIVINE SAVIOR HEALTHCARE INC
Long Term Care Pharmacy

A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.


Contact Information

DIVINE SAVIOR HEALTHCARE, INC.
2817 NEW PINERY ROAD
PORTAGE, WI53901
Phone: 608-745-5603
Fax: 608-742-6098
Website:
Specialty Taxonomy Code
* Long Term Care Pharmacy 3336L0003X

* Indicates primary specialty

NPI Profile & details for DIVINE SAVIOR HEALTHCARE, INC.

NPI Number 1831693100
Legal business name
LBN
DIVINE SAVIOR HEALTHCARE, INC.
Authorized official MARLIN NELSON - (CFO)
Entity Organization
Organization subpart Yes
Enumeration date 03/21/2018
Last updated 03/21/2018 - About 8 years ago
Sole proprietor1 Not specified
Identifiers
  • WI Medicaid: 33113100

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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