Organization
PHILLIPS TOMAH PHARMACY INC
Active
Other names
PHILLIPS TOMAH PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
WAYNE MACARDY RPH (PRESIDENT)
(800) 343-3784
Entity
Organization
Contact information
Practice address
1004 SUPERIOR AVE, TOMAH, WI 54660-2002
(608) 372-4115
(608) 372-4116
Mailing address
PO BOX 136, MAUSTON, WI 53948-0136
(800) 343-3784
(608) 847-5004
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
7805-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2113172
PK
—
05
—
33234400
—
WI
Enumeration date
02/02/2006
Last updated
07/19/2018
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