Healthcare Provider Details

I. General information

NPI: 1063781920
Provider Name (Legal Business Name): O CONNELL PHARMACY LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2011
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 S THOMPSON RD
SUN PRAIRIE WI
53590-2526
US

IV. Provider business mailing address

302 S GRAND AVE
SUN PRAIRIE WI
53590-9827
US

V. Phone/Fax

Practice location:
  • Phone: 608-837-8002
  • Fax: 608-478-3900
Mailing address:
  • Phone: 608-837-8002
  • Fax: 608-478-3900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number9103-42
License Number StateWI

VIII. Authorized Official

Name: MICHELLE O'CONNELL
Title or Position: OWNER
Credential:
Phone: 608-837-5949