Organization
PHILLIPS DRUG STORE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WAYNE MACARDY RPH (PRESIDENT)
(608) 847-5949
Entity
Organization
Contact information
Practice address
1040 DIVISION ST, MAUSTON, WI 53948
(608) 847-6155
(608) 847-2126
Mailing address
PO BOX 136, MAUSTON, WI 53948-0136
(608) 847-6155
(608) 847-2126
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
7013042
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33167100
—
WI
Enumeration date
02/02/2006
Last updated
08/22/2020
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