Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Nicolet Pharmacy Long Term Care

Organization Long Term Care Pharmacy · NPI 1063302990

Nicolet Pharmacy Long Term Care is a Long Term Care Pharmacy in Lakewood, Wisconsin. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

15481 Commercial Rd Ste A
Lakewood, WI 54138-9677
Phone: (715) 276-3646
Fax: (715) 276-9568
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Long Term Care Pharmacy (primary) Taxonomy 3336L0003X

Record details

NPI number1063302990
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationNicolet Pharmacy Inc
Authorized official Amy Donaldson — President · (715) 276-3646
NPI enumeratedJuly 3, 2025
Last updated in NPPESJuly 3, 2025
Certification dateJuly 3, 2025
Mailing address15481 Commercial Rd Ste A, Lakewood, WI 54138-9677