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Organization
SSM HEALTH CARE OF WISCONSIN, INC.
Active
Organization
SSM HEALTH CARE OF WISCONSIN, INC.
Active
Other names
ST MARYS CARE CENTER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
AUDREY RUFENACHT PHARMD (PHARMACIST)
(608) 845-0447
Entity
Organization
Contact information
Practice address
3401 MAPLE GROVE DR, MADISON, WI 53719-5013
(608) 845-0447
(608) 845-0449
Mailing address
3401 MAPLE GROVE DR, MADISON, WI 53719-5013
(608) 845-0447
(608) 845-0449
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
8247-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2115167
PK
—
05
—
33241000
—
WI
Enumeration date
10/31/2006
Last updated
10/25/2021
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