Organization
PHILLIPS REEDSBURG PHARMACY INC
Active
Other names
Phillips Nekoosa Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
WAYNE MACARDY RPH (PRESIDENT)
(608) 847-5949
Entity
Organization
Contact information
Practice address
232 MARKET ST, NEKOOSA, WI 54457-1122
(715) 886-3100
(715) 886-3105
Mailing address
PO BOX 136, MAUSTON, WI 53948-0136
(608) 847-5949
(608) 847-2670
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
8957-042
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5131812
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/06/2009
Last updated
12/10/2009
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