Organization
PHILLIPS ROCHE A CRI CLINIC PHARMACY INC
Active
Other names
PHILLIPS ROCHE A CRI PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
WAYNE MACARDY RPH (PRESIDENT)
(608) 847-5949
Entity
Organization
Contact information
Practice address
402 W LAKE ST, FRIENDSHIP, WI 53934-9699
(608) 339-9080
(608) 339-3023
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
8465-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2115259
PK
—
05
—
33187500
—
WI
Enumeration date
01/31/2006
Last updated
03/28/2017
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