# SSM HEALTH CARE OF WISCONSIN, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ST MARYS CARE CENTER PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407932536
- **Authorized official:** AUDREY RUFENACHT PHARMD (PHARMACIST)
- **Authorized official phone:** (608) 845-0447

## Contact information

- **Practice address:** 3401 MAPLE GROVE DR, MADISON, WI 53719-5013
- **Practice address phone:** (608) 845-0447
- **Practice address fax:** (608) 845-0449
- **Mailing address:** 3401 MAPLE GROVE DR, MADISON, WI 53719-5013
- **Mailing address phone:** (608) 845-0447
- **Mailing address fax:** (608) 845-0449

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | 8247-42 | WI | Yes |

## Other

- **Enumeration date:** 10/31/2006
- **Last updated:** 10/25/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2115167 | PK | — |
| 05 | — | 33241000 | — | WI |