Organization
GUNDERSEN CLINIC LTD
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
Legal business name
GUNDERSEN CLINIC LTD
Authorized official
TINA LECHNIR (VP CROSS-FUNCTIONAL CARE)
(608) 775-2600
Entity
Organization
Contact information
Practice address
505 KING ST STE 154, LA CROSSE, WI 54601-4062
(608) 782-4448
(608) 782-4449
Mailing address
505 KING ST STE 154, LA CROSSE, WI 54601-4062
(608) 782-4448
(608) 782-4449
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
9420-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100064708
—
WI
01
—
2163999
PK
—
Enumeration date
10/05/2016
Last updated
07/04/2025
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