PHILLIPS DRUG STORE (NPI# 1750353850) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750353850 |
| Entity Type | Organization |
| Organization Name | PHILLIPS DRUG STORE |
| Practice Address |
1040 Division St Mauston WI 53948 |
| Mailing Address |
Po Box 136 Mauston WI 53948-0136 |
| Practice Telephone | 6088476155 |
| Practice Fax Number | 6088472126 |
| Mailing Telephone | 6088476155 |
| Mailing Fax Number | 6088472126 |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | WAYNE MACARDY (PRESIDENT) |
| Authorized Official Telephone | 6088475949 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | 7013042 | WI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 33167100 | 05 |
| Street Address |
1040 DIVISION ST |
| City | MAUSTON |
| State | WI |
| Zip Code | 53948 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497749188 | Kimberley E. Sabey | Family Medicine | 1040 Division St, Mauston, WI 53948-1931 | 2005-09-08 |
| 1518464924 | Emily Bliss Walden | Advanced Practice Midwife | 1040 Division St, Mauston, WI 53948-1931 | 2018-04-11 |
| 1396110821 | Cassie Sullivan | Nurse Practitioner | 1040 Division St, Mauston, WI 53948-1931 | 2015-12-09 |
| 1306255021 | Ling Zhong | Physician Assistant | 1040 Division St, Mauston, WI 53948-1931 | 2014-08-06 |
| 1467895136 | Jenna K. Sebranek | Family Medicine | 1040 Division St, Mauston, WI 53948 | 2013-04-12 |
| 1881930527 | Mile Bluff Medical Center Inc | Clinic/Center | 1040 Division St, Mauston, WI 53948-1931 | 2012-12-28 |
| 1932458932 | Gregory E. Burgess | Physician Assistant | 1040 Division St, Mauston, WI 53948-1931 | 2012-09-05 |
| 1346563756 | Sandra K Hanko | Registered Nurse | 1040 Division St, Mauston, WI 53948-1931 | 2010-03-12 |
| 1396971115 | Eric Michael Ness | Family Medicine | 1040 Division St, Mauston, WI 53948-1931 | 2009-06-08 |
| 1417170788 | Angela Marie Gatzke-plamann | Family Medicine | 1040 Division St, Mauston, WI 53948-1931 | 2007-04-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114557691 | Paige Odegard | Case Manager/Care Coordinator | Juneau Co. Dept of Human Services, 200 Hickory Street, Mauston, WI 53948 | 2020-01-23 |
| 1083934418 | Brandon J Valgardson | Dentist | 880 Herriott Drive, Mauston, WI 53948 | 2010-06-08 |
| 1235451204 | Robin Adair Thompson | Dental Hygienist | 880 Herriot Drive, Mauston, WI 53948 | 2010-02-18 |
| 1114169943 | Ptworks LLC | Clinic/Center | 690 Kennedy Street, Mauston, WI 53948 | 2009-03-25 |
| 1609901529 | Mary Ann Brown | Physical Therapy Assistant | N3334 Hwy 58, Mauston, WI 53948 | 2007-02-22 |
| 1497809412 | Bobbi Eckerman | Occupational Therapist | 1050 Division St., Mauston, WI 53948 | 2007-01-23 |
| 1215092820 | Patrick Michael Mccormick | Dentist | 510 E State St, Mauston, WI 53948 | 2006-12-26 |
| 1093772287 | Ann Marie June | Social Worker | Juneau County Dept of Human Services, 200 Hickory St, Mauston, WI 53948 | 2006-05-01 |
| 1740252857 | Phillips Drug Store, Inc. | Pharmacy | 123 E State St, Mauston, WI 53948 | 2006-02-02 |
| 1336781574 | Leah Bernadette Doughty | Physician Assistant | 1050 Division St, Urgent Care/ed, Mauston, WI 53948 | 2019-10-09 |
| Find all providers in zip 53948 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740252857 | Phillips Drug Store, Inc. | Pharmacy | 123 E State St, Mauston, WI 53948 | 2006-02-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497355002 | Long Life Pharmacy 2 LLC | Pharmacy | 1225 W Historic Mitchell St Ste 217, Milwaukee, WI 53204-3382 | 2020-11-01 |
| 1710527783 | Sage Specialty Pharmacy Inc. | Pharmacy | 4001 N. Oakland Ave, Shorewood, WI 53211 | 2020-01-08 |
| 1790333623 | Froedtert Health Pharmacy LLC | Pharmacy | 9200 W Wisconsin Ave Ste 200w, Milwaukee, WI 53226-3522 | 2019-09-04 |
| 1225686405 | Froedtert Health Pharmacy LLC | Pharmacy | 9200 W Wisconsin Ave Ste 200c, Milwaukee, WI 53226-3522 | 2019-08-30 |
| 1134777337 | Froedtert Health Pharmacy LLC | Pharmacy | 11430 N Port Washington Rd Ste 103, Mequon, WI 53092-3414 | 2019-08-30 |
| 1619524766 | University Rx LLC | Pharmacy | 133 E College Ave, Appleton, WI 54911 | 2019-08-23 |
| 1053967026 | Accurabenefits, LLC | Pharmacy | 2413 Woodland Ter, Neenah, WI 54956-4824 | 2019-08-14 |
| 1184276917 | St. Clare Health Mission Pharmacy | Pharmacy | 916 Ferry St, La Crosse, WI 54601-4717 | 2019-07-11 |
| 1851851141 | Dean Retail Services, Inc. | Pharmacy | 740 Reena Ave Ste 300, Fort Atkinson, WI 53538-3145 | 2019-03-22 |
| 1093287237 | Del Mar Pharmacy Sc | Pharmacy | 1000 S Cesar E Chavez Dr, Milwaukee, WI 53204-2203 | 2018-12-28 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.