National Provider Identifier Database

PHILLIPS DRUG STORE
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.


Contact Information

PHILLIPS DRUG STORE
1040 DIVISION ST
MAUSTON, WI53948
Phone: 608-847-6155
Fax: 608-847-2126
Website:
Specialty Taxonomy Code
* Pharmacy 333600000X

* Indicates primary specialty

NPI Profile & details for PHILLIPS DRUG STORE

NPI Number 1750353850
Legal business name
LBN
PHILLIPS DRUG STORE
Authorized official WAYNE MACARDY - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 02/02/2006
Last updated 08/22/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • WI License #: 7013042
  • WI Medicaid: 33167100

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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