Organization · Type 2 NPI

Ericksons Diversified LLC

Community/Retail Pharmacy · New Richmond, WI

NPI number 1114075488 Active

Practice location

110 W 4th St
New Richmond, WI 54017-1722

Call (715) 246-2186 Map

Fax (715) 246-7115

Mailing address

1527 Momentum Pl
Chicago, IL 60689-5315

Specialties and licenses

Taxonomy	Code	License
Pharmacy	333600000X	5254 (WI)
Community/Retail Pharmacy Primary	3336C0003X	None listed

Community/Retail Pharmacy: A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other …

6 other providers at this address

Other community/retail pharmacy providers in New Richmond

See all in New Richmond →

NPI record

NPI: 1114075488
Entity type: Organization (Type 2)
Issued: Jan 5, 2007
Last updated: Oct 31, 2025
Status: Active

Other names

<unavail>
Family Fresh Market Pharmacy · doing business as
Family Fresh Market Pharmacy · doing business as

Authorized official

Amy Ellis, RPH
Director of Pharmacy
(616) 878-2848

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

Is this your record? How to update it.

About NPI 1114075488

Ericksons Diversified LLC's National Provider Identifier is 1114075488, issued on Jan 5, 2007. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in New Richmond, WI. The record was last updated on Oct 31, 2025.