# GUNDERSEN CLINIC LTD

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** GUNDERSEN CLINIC LTD
- **Other names:** Medpak Pharmacy Gundersen Health System, Gundersen Long Term Care Pharmacy
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1699225474
- **Legal business name:** GUNDERSEN CLINIC LTD
- **Authorized official:** TINA LECHNIR (VP CROSS-FUNCTIONAL CARE)
- **Authorized official phone:** (608) 775-2600

## Contact information

- **Practice address:** 505 KING ST STE 154, LA CROSSE, WI 54601-4062
- **Practice address phone:** (608) 782-4448
- **Practice address fax:** (608) 782-4449
- **Mailing address:** 505 KING ST STE 154, LA CROSSE, WI 54601-4062
- **Mailing address phone:** (608) 782-4448
- **Mailing address fax:** (608) 782-4449

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | 9420-42 | WI | Yes |

## Other

- **Enumeration date:** 10/05/2016
- **Last updated:** 07/04/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100064708 | — | WI |
| 01 | — | 2163999 | PK | — |