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Contact Information

PHILLIPS DRUG STORE
1040 DIVISION ST
MAUSTON, WI53948
 Phone: 608-847-6155
 Fax: 608-847-2126
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for PHILLIPS DRUG STORE

NPI Number 1750353850
LBN Legal business name PHILLIPS DRUG STORE
Authorized official WAYNE MACARDY - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 02/02/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
WI License # 7013042
WI Medicaid 33167100
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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