Organization
GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN
Active
Other names
GHC SAUK TRAILS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LAURIE FLAGEL DEAN RPH (OPERATION COORDINATOR)
(608) 828-4811
Entity
Organization
Contact information
Practice address
8202 EXCELSIOR DR, MADISON, WI 53717-1906
(608) 831-1773
(608) 828-4843
Mailing address
PO BOX 44971, MADISON, WI 53744-4971
(608) 828-4811
(608) 828-4810
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
—
—
3336M0003X
Managed Care Organization Pharmacy
Primary
7386-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2108702
PK
—
Enumeration date
08/10/2006
Last updated
09/30/2016
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