# AMERY REGIONAL MEDICAL CENTER, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Amery Community Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891387502
- **Authorized official:** DEBRA ANNELFSTROM RUDQUIST (CEO/PRESIDENT)
- **Authorized official phone:** (715) 268-0300

## Contact information

- **Practice address:** 265 GRIFFIN ST E, AMERY, WI 54001-1439
- **Practice address phone:** (715) 268-0678
- **Practice address fax:** (715) 268-0679
- **Mailing address:** 265 GRIFFIN ST E, AMERY, WI 54001-1439
- **Mailing address phone:** (715) 268-0678
- **Mailing address fax:** (715) 268-0679

## Taxonomy

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

## Other

- **Enumeration date:** 02/04/2021
- **Last updated:** 02/04/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 9660-42 | WI BOARD PHARMACY LICENSE | WI |