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
—
—
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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