# PHILLIPS ROCHE A CRI CLINIC PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PHILLIPS ROCHE A CRI PHARMACY INC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841261302
- **Authorized official:** WAYNE MACARDY RPH (PRESIDENT)
- **Authorized official phone:** (608) 847-5949

## Contact information

- **Practice address:** 402 W LAKE ST, FRIENDSHIP, WI 53934-9699
- **Practice address phone:** (608) 339-9080
- **Practice address fax:** (608) 339-3023
- **Mailing address:** PO BOX 136, MAUSTON, WI 53948-0136
- **Mailing address phone:** (800) 343-3784
- **Mailing address fax:** (608) 847-5004

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 8465-42 | WI | Yes |

## Other

- **Enumeration date:** 01/31/2006
- **Last updated:** 03/28/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2115259 | PK | — |
| 05 | — | 33187500 | — | WI |