# GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN

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- **Entity:** Organization
- **Status:** Active
- **Other names:** GHC SAUK TRAILS PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346251840
- **Authorized official:** LAURIE FLAGEL DEAN RPH (OPERATION COORDINATOR)
- **Authorized official phone:** (608) 828-4811

## Contact information

- **Practice address:** 8202 EXCELSIOR DR, MADISON, WI 53717-1906
- **Practice address phone:** (608) 831-1773
- **Practice address fax:** (608) 828-4843
- **Mailing address:** PO BOX 44971, MADISON, WI 53744-4971
- **Mailing address phone:** (608) 828-4811
- **Mailing address fax:** (608) 828-4810

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0002X | Clinic Pharmacy | — | NULL | — |
| 3336M0003X | Managed Care Organization Pharmacy | 7386-42 | WI | Yes |

## Other

- **Enumeration date:** 08/10/2006
- **Last updated:** 09/30/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2108702 | PK | — |