1570 midway Place menasha,wi 54952 800-378-5234 TTy 800-947-3529 monday Friday, 8 a.m. to 8 p.m. NetworkHealthmedicare.com NetworkCares (PPO snp) Network PlatinumPlus Pharmacy (PPO) Network PlatinumPremier Pharmacy (PPO) Network PlatinumSelect (PPO) H5215_RXPD/13_V1 CMS ACCEPTED 09052013 NETwOrk HEaLTH medicare advantage PLaNs Network Health Insurance corporation 2013 PHarmacy DIrEcTOry
Network PlatinumPlus Pharmacy (PPO) Network PlatinumPremier Pharmacy (PPO) NetworkCares (PPO SNP) Network PlatinumSelect (PPO) Pharmacy Directory This booklet provides a list of Network PlatinumPlus Pharmacy, Network PlantinumPremier Pharmacy, NetworkCares and Network PlatinumSelect s network pharmacies. We also list pharmacies that are in our network but are outside of our service area. Please contact Network Health Medicare Advantage Plans at 800-316-3107, 24 hours a day/7 days a week, for additional information. All network pharmacies may not be listed in this directory. Pharmacies may have been added or removed from the list after this directory was printed. To get current information about Network Health Medicare Advantage Plans network pharmacies in your area, please visit our website at networkhealthmedicare.com or call our customer service at 800-316- 3107, 24 hours a day/7 days a week. (TTY/TDD users should call 800-899-2114.) Beneficiaries must use network pharmacies to access their prescription drug benefit. Benefits, formulary, pharmacy network, premium and/or copayments/coinsurance may change on January 1, 2014. Network Health Insurance Corporation is a Medicare Advantage Organization with a Medicare Contract. To receive this document in an alternate format, please call Customer Service at 800-378-5234, TTY/TDD users call 800-947-3529. We are open Monday through Friday, 8 a.m. to 8 p.m. From October 1, 2012 through February 14, 2013 we are available 7 days a week from 8 a.m. to 8 p.m. H5215_RXPD/13_V1 CMS Accepted 09052012
TABLE OF CONTENTS Introduction... 1... 2 Mail Order Pharmacy... 12 Home Infusion Pharmacies... 13 Long-Term Care Pharmacies... 14 Indian Health Service/Tribal/Urban Indian Health Program (I/T/U) Pharmacies... 16 NETWORK HEALTH INSURANCE CORPORATION 1570 Midway Place PO Box 120 Menasha, WI 54952 Customer Service 1-800-316-3107 24 hours a day/7 days a week TTY/TDD 1-800-899-2114
Introduction This booklet provides a list of Network Health Medicare Advantage Plan s network pharmacies. To get a complete description of your prescription coverage, including how to fill your prescriptions, please review the Evidence of Coverage and Network Health Medicare Advantage Plan s formulary. If you have additional questions, please call customer service at 800-316-3107, 24 hours a day/7 days a week. TTY/TDD users should call 800-899-2114. Or, visit networkhealthmedicare.com. We call the pharmacies on this list our network pharmacies because we have made arrangements with them to provide prescription drugs to Plan members. In most cases, your prescriptions are covered under Network Health Medicare Advantage Plans only if they are filled at a network pharmacy or through our mail order pharmacy service. Once you go to one, you are not required to continue going to the same pharmacy to fill your prescription. You can go to any of our network pharmacies. We will fill prescriptions at nonnetwork pharmacies under certain circumstances as described in your Evidence of Coverage. Preferred pharmacies are network pharmacies with which our Plan has negotiated even lower cost-sharing for its plan members for covered prescription drugs than at non-preferred pharmacies. However, you will still have access to lower drug prices at non-preferred pharmacies than at out-of-network pharmacies. You may go to either of these types of network pharmacies to receive your covered prescription drugs. Network Health Medicare Advantage Plan s Network Pharmacies This directory contains the different types of pharmacies in our network. These pharmacies are listed alphabetically by community. To locate a participating pharmacy, find the community nearest you and check the listing of participating pharmacies. Or, you can visit our website at networkhealthmedicare.com or call our Customer Service at 800-316-3107, 24 hours a day/7 days a week. TTY/TDD users should call 800-899-2114. Legend * Preferred Pharmacy # Extended Supply Pharmacy. This pharmacy can provide a long-term supply of maintenance drugs. 1
Algoma 801 Jefferson St Algoma WI 54201 (920) 487-2887 Appleton Consumer Prescription 2310 W College Ave Appleton WI 54914 (920) 739-9232 Copps Food Center 2700 N Ballard Rd Appleton WI 54911 (920) 996-0121 Copps Food Center 511 W Calumet St Appleton WI 54915 (920) 734-3882 CVS 1485 Oneida St Appleton WI 54915 (920) 733-1194 CVS 700 W Wisconsin Ave Appleton WI 54914 (920) 991-1190 Sam's Club 4895 Integrity Way Appleton WI 54915 (920) 733-7410 Shopko Express Pharmacy 2101 E Evergreen Dr Appleton WI 54913 (920) 733-2305 Shopko Express Pharmacy W3208 Van Roy Rd Appleton WI 54915 (920) 733-3846 1000 W Northland Ave Appleton WI 54914 (920) 739-6871 Target Pharmacy 1800 South Kensington Dr Appleton WI 54915 (920) 749-9775 3701 E Calumet St Appleton WI 54915 (920) 996-0746 955 N Mutual Way Appleton WI 54913 (920) 954-6400 1901 S Oneida St Appleton WI 54915 (920) 739-7321 2803 N Meade St Appleton WI 54911 (920) 830-6985 3330 E Calumet St Appleton WI 54915 (920) 733-3016 700 W College Ave Appleton WI 54914 (920) 733-6599 729 W Northland Ave Appleton WI 54914 (920) 954-8100 Ashwaubenon 2301 S Oneida St Ashwaubenon WI 54304 (920) 490-0424 2
Beaver Dam Marshland 705 S University Ave Beaver Dam WI 53916 (920) 356-0040 822 Park Ave Beaver Dam WI 53916 (920) 887-7461 Thrifty White Drug 609 N Spring St Beaver Dam WI 53916 (920) 885-3277 120 Francis Ln Beaver Dam WI 53916 (920) 885-5808 607 Park Ave Beaver Dam WI 53916 (920) 356-0148 Bellevue 1979 Lime Kiln Rd Bellevue WI 54311 (920) 288-0638 Berlin Field 135 W Huron St Berlin WI 54923 (920) 361-1565 822 Broadway St Berlin WI 54923 (920) 361-3433 Brillion 1010 W Ryan St Brillion WI 54110 (920) 756-2640 Brownsville Agnesian 900 Main St Brownsville WI 53006 (920) 583-1310 Campbellsport The Village Apothecary 110 W Main St Campbellsport WI 53010 (920) 533-4012 Cedar Grove 313 S Main St Cedar Grove WI 53013 (920) 668-6286 Chilton 810 S Irish Rd Chilton WI 53014 (920) 849-7330 245 W Calumet St Chilton WI 53014 (920) 849-2818 Clintonville Erickson 8 S Main St STE B Clintonville WI 54929 (715) 823-2222 291 S Main St Clintonville WI 54929 (715) 823-2350 201 S Main St Clintonville WI 54929 (715) 823-4238 De Pere 1881 Chicago St De Pere WI 54115 (920) 403-8050 Shopko Express 3705 Monroe Rd De Pere WI 54115 (920) 336-6096 230 N Wisconsin St De Pere WI 54115 (920) 336-2323 Stowe Drug Store 375 Main Ave De Pere WI 54115 (920) 336-6128 3
De Pere (continued) 1415 Lawrence Dr De Pere WI 54115 (920) 336-7168 901 Main Ave De Pere WI 54115 (920) 983-6153 Denmark Bellin Health Pharmacy 595 County Road R Denmark WI 54208 (920) 863-5800 Fond du Lac Agnesian 145 N Main St (920) 926-4660 Agnesian 912 S Hickory Rd (920) 929-7480 Agnesian Pharmacy Plus 420 E Division St (920) 926-8585 210 Wisconsin American Dr (920) 907-7260 Kremer 9 N Main St (920) 921-2550 Pick N Save 55 W Pioneer Rd (920) 923-7780 Pick N Save 760 W Johnson St (920) 929-7422 616 W Johnson St (920) 921-5490 Target Pharmacy 485 N Rolling Meadows Dr Fond du Lac WI 54937 (920) 924-0420 377 N Rolling Meadows Dr (920) 921-9591 192 N Main St (920) 921-5264 20 W Pioneer Rd (920) 907-0556 Grand Chute Copps Food Center 2400 W Wisconsin Ave Grand Chute WI 54914 (920) 831-0400 1305 N Casaloma Dr Grand Chute WI 54913 (920) 730-8218 Green Bay Aurora Green Bay Clinic Disp 2253 W Mason St Green Bay WI 54303 (920) 327-7220 2845 Green Brier Rd Green Bay WI 54311 (920) 288-3140 Aurora Visiting Nurse Assoc 931 Discovery Ave Green Bay WI 54311 (920) 288-5141 Bellin Health Pharmacy 1630 Commanche Ave STE 102 Green Bay WI 54313 (920) 430-4555 Bellin Health Pharmacy 3263 Eaton Rd Green Bay WI 54311 (920) 433-6790 4
Green Bay (continued) Bellin Health Pharmacy 744 S Webster Ave Green Bay WI 54301 (920) 431-5696 Copps Food Center 1291 Lombardi Access Rd Green Bay WI 54304 (920) 498-9783 Copps Food Center 1819 Main St Green Bay WI 54302 (920) 469-3436 CVS 1561 W Mason St Green Bay WI 54303 (920) 497-5959 CVS 2222 S Webster Ave Green Bay WI 54301 (920) 430-8089 CVS 2400 Velp Ave Green Bay WI 54303 (920) 434-3954 CVS 930 Main St Green Bay WI 54301 (920) 436-9382 Kmart 1109 Lombardi Ave Green Bay WI 54304 (920) 499-6004 Krider Pharmacy and Gifts 1119 W Mason St Green Bay WI 54303 (920) 499-6225 Sam's Club 2470 W Mason St Green Bay WI 54303 (920) 494-0536 Shopko Express 2585 Lineville Rd Green Bay WI 54313 (920) 662-9450 216 S Military Ave Green Bay WI 54303 (920) 499-0895 2320 Lineville Rd Green Bay WI 54313 (920) 434-5846 2430 E Mason St Green Bay WI 54302 (920) 468-6044 301 Bay Park Sq Green Bay WI 54304 (920) 499-5889 Streus 635 Main St Green Bay WI 54301 (920) 437-0206 Target Pharmacy 1001 Cormier Rd Green Bay WI 54304 (920) 499-2608 Target Pharmacy 2050 Lime Kiln Rd Green Bay WI 54311 (920) 406-9049 2292 Main St Green Bay WI 54311 (920) 465-7737 2440 W Mason St Green Bay WI 54303 (920) 499-2330 116 N Military Ave Green Bay WI 54303 (920) 498-3247 1165 W Mason St Green Bay WI 54303 (920) 498-3794 1401 E Mason St Green Bay WI 54301 (920) 435-7679 1995 Main St Green Bay WI 54302 (920) 465-6210 2204 University Ave Green Bay WI 54302 (920) 469-5516 464 Cardinal Ln Green Bay WI 54313 (920) 661-9355 5
Horicon Kiel Lomira Marshland 700 Washington St Horicon WI 53032 (920) 485-3400 Howards Grove 620 S Wisconsin Dr Howards Grove WI 53083 (920) 565-5425 Iola Sweet Med Prescriptions Plus 155 N Main St Iola WI 54945 (715) 445-3117 Kaukauna 2700 Crooks Ave Kaukauna WI 54130 (920) 759-3050 2412 Crooks Ave Kaukauna WI 54130 (920) 759-9165 Kewaunee 802 N Main St Kewaunee WI 54216 (920) 388-2915 1001 Service Rd Kiel WI 53042 (920) 894-4370 1120 State Road 67 Kiel WI 53042 (920) 894-3604 Kimberly 800 E Maes St Kimberly WI 54136 (920) 788-9154 Kohler 795C Woodlake Rd Kohler WI 53044 (920) 459-8768 Lakewood Nicolet Pharmacy 15481 Commercial Rd Lakewood WI 54138 (715) 276-3646 Little Chute 219 W Main St Little Chute WI 54140 (920) 687-6193 Aurora Pres Dispensing Cntr 375 East Ave STE 1 Lomira WI 53048 (920) 269-2080 Luxemburg Luxemburg Pharmacy 125 School Creek Trl Luxemburg WI 54217 (920) 845-5832 Manitowoc 601 Reed Ave Manitowoc WI 54221 (920) 686-5237 Copps Food Center 3300 Calumet Ave Manitowoc WI 54220 (920) 682-3051 Custom Health Pharmacy 1011 S 10th St Manitowoc WI 54220 (920) 482-3145 CVS 701 E Reed Ave Manitowoc WI 54220 (920) 682-3726 Health Mart Manitowoc Phcys 919 S 8th St Manitowoc WI 54220 (920) 684-6789 6
Manitowoc (continued) HFM Meds To Go 1650 S 41st St Manitowoc WI 54220 (920) 320-4550 HFM 3310 Calumet Ave Manitowoc WI 54220 (920) 320-4440 3415 Calumet Ave Manitowoc WI 54220 (920) 684-0251 4115 Calumet Ave Manitowoc WI 54220 (920) 684-5016 2702 Calumet Ave Manitowoc WI 54220 (920) 683-8887 Markesan Agnesian 49 S Bridge St Markesan WI 53946 (920) 398-3261 Mayville Agnesian 360 S Mountain Dr Mayville WI 53050 (920) 387-7570 Marshland 1028 Horicon St Mayville WI 53050 (920) 387-7800 Menasha 1578 Appleton Rd Menasha WI 54952 (920) 722-1895 305 Racine St Menasha WI 54952 (920) 722-4759 Montello Bentley Drug Store 25 W Montello St Montello WI 53949 (608) 297-2474 Neenah CVS 901 S Green Bay Rd Neenah WI 54956 (920) 729-1448 Pick N Save 828 Fox Point Plz Neenah WI 54956 (920) 722-1348 699 Green Bay Rd Neenah WI 54956 (920) 751-0270 1155 Winneconne Ave Neenah WI 54956 (920) 722-1185 1191 W Towne Dr Neenah WI 54956 (920) 725-3152 500 S Commercial St Neenah WI 54956 (920) 729-1311 New London Jernegan's Health Mart 1301 Mill St New London WI 54961 (920) 982-7670 1717 N Shawano St New London WI 54961 (920) 982-7906 981 N Shawano St New London WI 54961 (920) 982-5189 North Fond du Lac Agnesian 723 Park Ridge Ln North Fond du Lac WI 54937 (920) 926-8660 7
Oconto Oconto 1008 Main St Oconto WI 54153 (920) 834-4455 126 Charles St Oconto WI 54153 (920) 834-9800 Oconto Falls CMH 855 S Main St Oconto Falls WI 54154 (920) 846-8059 Oconto Falls Pharmacy HM 323 E Highland Dr Oconto Falls WI 54154 (920) 848-3721 Omro Omro 109 E Main St Omro WI 54963 (920) 685-5041 Oshkosh 2101 Bowen St Oshkosh WI 54901 (920) 303-5006 855 N Westhaven Dr Oshkosh WI 54904 (920) 303-8830 Pick N Save 1940 S Koeller St Oshkosh WI 54902 (920) 236-9494 Schultz 220 N Main St Oshkosh WI 54901 (920) 233-2151 1300 Koeller Rd Oshkosh WI 54901 (920) 426-5770 Target Pharmacy 1900 S Koeller St Oshkosh WI 54902 (920) 233-4287 351 S Washburn St Oshkosh WI 54904 (920) 231-2219 1100 Emmers Ln Oshkosh WI 54904 (920) 237-4753 315 W Murdock Ave Oshkosh WI 54901 (920) 231-8664 950 S Koeller St Oshkosh WI 54902 (920) 303-1712 Plover Copps Food Center 1850 Plover Rd Plover WI 54467 (715) 344-0066 1800 Plover Rd Plover WI 54467 (715) 342-9368 250 Crossroads Dr Plover WI 54467 (715) 345-7870 Plymouth 2635 Eastern Ave Plymouth WI 53073 (920) 893-1442 Kmart 2615 Eastern Ave Plymouth WI 53073 (920) 892-4182 428 Walton Dr Plymouth WI 53073 (920) 892-2656 2455 Eastern Ave Plymouth WI 53073 (920) 893-5895 8
Princeton Bentley Drug 528 W Water St Princeton WI 54968 (920) 295-6271 Pulaski Pulaski Health Mart 121 N Saint Augustine St Pulaski WI 54162 (920) 822-3011 Reeseville Village Healthmart 202 S Main St Reeseville WI 53579 (920) 927-3305 Ripon Kmart 1200 W Fond du Lac St Ripon WI 54971 (920) 748-1203 Ripon Drug 328 Watson St Ripon WI 54971 (920) 748-5174 1203 W Fond du Lac St Ripon WI 54971 (920) 748-6005 Seymour 1010 S Mainline Dr Seymour WI 54165 (920) 833-0430 Shawano Dreier Health Mart 117 S Main St Shawano WI 54166 (715) 526-2011 Kmart 1211 E Green Bay St Shawano WI 54166 (715) 526-6551 Thedacare 100 County Road B Shawano WI 54166 (715) 526-3456 1244 E Green Bay St Shawano WI 54166 (715) 524-5983 401 E Green Bay St Shawano WI 54166 (715) 524-5600 Sheboygan 2414 Kohler Memorial Dr (920) 459-2630 509 Superior Ave (920) 459-2637 Glander Prescription Plus 3529 Superior Ave (920) 459-2755 Pick N Save 1317 N 25th St (920) 457-5839 Pick N Save 2625 S Business Dr (920) 452-2739 Sheboygan Health Mart 577 S Taylor Dr (920) 459-7467 518 S Taylor Dr (920) 458-0040 3711 S Taylor Dr (920) 459-8601 4433 Vanguard Dr (920) 459-9470 9
Sheboygan (continued) 1029 N 14th St (920) 458-7707 2702 Calumet Dr Sheboygan WI 53083 (920) 457-5656 3320 S Business Dr (920) 452-5858 Sheboygan Falls Target Pharmacy 4085 State Highway 28 Sheboygan Falls WI 53085 (920) 451-8448 Stevens Point Copps Food Center 5657 Us Highway 10 E Stevens Point WI 54482 (715) 345-7175 Kmart 111 Division St N Stevens Point WI 54481 (715) 341-5613 1200 Main St Stevens Point WI 54481 (715) 344-1230 Trigs County Market 1600 Academy Ave Stevens Point WI 54481 (715) 341-6102 10 Park Ridge Dr Stevens Point WI 54481 (715) 344-7368 3301 Church St Stevens Point WI 54481 (715) 345-2843 900 Illinois Ave Stevens Point WI 54481 (715) 344-6834 Two Rivers 2219 Garfield St STE 100 Two Rivers WI 54241 (920) 794-8029 5300 Memorial Dr Two Rivers WI 54241 (920) 793-7380 Medicine Shoppe 1500 Washington St Two Rivers WI 54241 (920) 794-1225 2206 Washington St Two Rivers WI 54241 (920) 793-8352 Waupaca Kmart 830 W Fulton St Waupaca WI 54981 (715) 258-4285 Riverside Clinic Pharmacy 800 Riverside Dr Waupaca WI 54981 (715) 256-1115 Stratton Drug Store 107 N Main St Waupaca WI 54981 (715) 258-7057 925 W Fulton St Waupaca WI 54981 (715) 258-9228 Waupaca Woods Pharmacy HM 101 N Western Ave Waupaca WI 54981 (715) 258-7621 Waupun Agnesian 904 W Main St Waupun WI 53963 (920) 324-3010 999 E Main St Waupun WI 53963 (920) 324-4696 10
Wautoma 900 E Division St Wautoma WI 54982 (920) 787-6940 CHN N2934 State Road 22 Wautoma WI 54982 (920) 787-5757 N2585 Plaza Rd Wautoma WI 54982 (920) 787-2090 Wrightstown Bellin Health Remote Disp 555 Quality Ct Wrightstown WI 54180 (920) 532-0700 Westfield Bentley 206 S Main St Westfield WI 53964 (608) 296-2877 Winneconne 916 E Main St Winneconne WI 54986 (920) 582-4414 Wittenberg Gwidt HM 203 E Westgor Ave Wittenberg WI 54499 (715) 253-2164 11
Mail Order Pharmacy Express Scripts, Inc. (800) 316-3107 TTY (800) 899-2114 Mail Order Pharmacy 12
Home Infusion Pharmacies Network Health Medicare Advantage Plans will cover Part D drugs used for home infusion therapy if: Your prescription drug is on Network Health Medicare Advantage Plan's formulary or you have a formulary exception; Network Health Medicare Advantage Plans has approved your prescription drug for home infusion therapy; and Your prescription is written by an authorized prescriber. Affinity Home Care Plus (HI) 2074 American Dr STE A Neenah WI 54956 (715) 387-0755 Home Care Pharmacy (HI) 5665 S Westridge Dr New Berlin WI 53151 (262) 786-9870 US Bioservices (HI) 5100 E Hunter Ave STE 101 Anaheim CA 92807 (800) 801-1140 Apria Healthcare (HI) 5345 S Moorland Rd New Berlin WI 53151 (262) 207-1590 Aurora Pharmacy (HI) 801 Jefferson St Algoma WI 54201 (920) 487-2887 Bio Rx (HI) 10828 Kenwood Rd Blue Ash OH 45242 (513) 792-7080 Chartwell Midwest Wisconsin (HI) 2241 Pinehurst Dr Middleton WI 53562 (608) 831-8555 Igg of America (HI) 514 Progress Dr STE X Linthicum MD 21090 (877) 674-9700 Ministry Home Care Plus (HI) 1927 N Central Ave STE B Marshfield WI 54449 (715) 387-0755 Option Care (HI) 985 Avenue Of The Cities Silvis IL 61282 (309) 762-7979 Pentech Health (HI) 4 Creek Pkwy STE A Boothwyn PA 19061 (800) 223-4376 US Bioservices (HI) 109 Chelsea Pkwy Boothwyn PA 19061 (800) 400-9549 US Bioservices (HI) 501 W 44th Ave Unit A Denver CO 80216 (800) 809-0647 US Bioservices (HI) 3200 Internet Blvd Frisco TX 75034 (888) 518-7246 US Bioservices (HI) 8028 Reeder Rd Lenexa KS 66214 (800) 860-6581 Home Infusion Pharmacies Coram Specialty Infusion Svcs (HI) 5345 S Moorland Rd STE 101 New Berlin WI 53151 (262) 207-1590 Thedacare Infusion Pharmacy (HI) 1818 N Meade St Appleton WI 54911 (920) 831-1892 13
Long-Term Care Pharmacies Residents of a long-term care facility may access their prescription drugs covered under Network Health Medicare Advantage Plans through the facility's long-term care pharmacy or another network long-term care pharmacy. Appleton King Menasha Long-Term Care Pharmacies Shopko Rxcare (LTC) 3701 E Evergreen Dr Appleton WI 54913 (920) 739-5900 Beaver Dam Thrifty White Drug (LTC) 609 N Spring St Beaver Dam WI 53916 (920) 885-3277 Green Bay Streus Pharmacy (LTC) 528 N Monroe Ave Green Bay WI 54301 (920) 437-0206 Greenville NCS Healthcare (LTC) N926 Tower View Dr Greenville WI 54942 (800) 236-5665 Wisconsin Veterans Home Phcy (LTC) N2665 County Rd Qq King WI 54946 (715) 258-1674 La Crosse Pinnacle Phcy of La Crosse (LTC) 3235 Airport Rd La Crosse WI 54603 (608) 781-7900 Madison Genoa Healthcare (LTC) 625 W Washington Ave Madison WI 53703 (608) 251-1838 Pinnacle Pharmacy (LTC) 2818 Progress Rd Madison WI 53716 (608) 216-0140 Willow Pharmacy (LTC) 2702 International Ln Madison WI 53704 (608) 240-2280 Morton Pharmacy (LTC) 712 Midway Rd Menasha WI 54952 (920) 886-2908 Milwaukee Roeschen's Omnicare Pharmacy (LTC) 5185 S 9th St Milwaukee WI 53221 (414) 486-3100 Monona Shopko Rxcare (LTC) 2217 Industrial Dr Monona WI 53713 (608) 223-0054 New London Jernegan's Health Mart (LTC) 1301 Mill St New London WI 54961 (920) 982-7670 14
Part D Pharmacy Directory: CY2012 Long-Term Care Pharmacies Oshkosh LHO Pharmacy 225 N Eagle St Oshkosh WI 54902 (920) 966-1345 Pewaukee Pharmerica (LTC) N29 W23721 Woodgate Ct W Pewaukee WI 53072 (262) 347-0926 Ripon Ripon Drug (LTC) 328 Watson St Ripon WI 54971 (920) 748-5174 Two Rivers Medicine Shoppe Pharmacy (LTC) 1500 Washington St Two Rivers WI 54241 (920) 794-1225 Wittenberg Gwidt Pharmacy (LTC) 203 E Westgor Ave STE 1 Wittenberg WI 54499 (715) 253-2164 Long-Term Care Pharmacies 15
I/T/U Pharmacies Indian Health Service/Tribal/Urban Indian Health Program (I/T/U) Pharmacies Only Native Americans and Alaska Natives have access to Indian Health Service / Tribal / Urban Indian Health Program (I/T/U) Pharmacies through Network Health Medicare Advantage Plan's pharmacy network. Those other than Native Americans and Alaskan Natives may be able to access these pharmacies under limited circumstances (e.g., emergencies). Bowler Stockbridge-Muncy Hlth Ctr Phy (I/T/U) W12802 County Road A Bowler WI 54416 (715) 793-4144 Oneida Oneida Comm Health Center Phcy (I/T/U) 525 Airport Dr Oneida WI 54155 (920) 869-2711 16
Network Health Insurance corporation 1570 midway Place menasha,wi 54952 800-378-5234 TTy 800-947-3529 monday Friday, 8 a.m. to 8 p.m. NetworkHealthmedicare.com NetworkCares (PPO snp) Network PlatinumPlus Pharmacy (PPO) Network PlatinumPremier Pharmacy (PPO) Network PlatinumSelect (PPO) H5215_RXPD/13_V1 CMS ACCEPTED 09052013