NPIMap

Organization Active NPI

Group Health Cooperative of South Central Wisconsin

Doing business as GHC Sauk Trails Pharmacy

  • Managed Care Organization Pharmacy
  • Madison, WI
National Provider Identifier
1346251840
Registry record updated Sep 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Managed Care Organization PharmacyTaxonomy code 3336M0003X
License
7386-42 Issued in WI
Legal business name
GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN
Doing business as
GHC Sauk Trails Pharmacy
Practice address
8202 Excelsior Dr
Madison, WI 53717-1906
Phone
(608) 831-1773
Fax
(608) 828-4843
NPI assigned
Aug 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Laurie Flagel Dean, RPH
Title
Operation Coordinator
Phone
(608) 828-4811

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X
Managed Care Organization Pharmacy 3336M0003X 7386-42 WI Primary

Addresses

Primary practice location

8202 Excelsior Dr
Madison, WI 53717-1906

Mailing address

PO Box 44971
Madison, WI 53744-4971
Phone (608) 828-4811

Other identifiers 1

IdentifierTypeStateIssuer
2108702OtherPK

Other names 1

  • GHC SAUK TRAILS PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Group Health Cooperative of South Central Wi - Admin16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

Locations

8202 Excelsior Dr
Madison, WI 53717
Phone (608) 831-1766

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475193600000",
    "number": "1346251840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44971",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537444971",
            "telephone_number": "608-828-4811",
            "fax_number": "608-828-4810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8202 EXCELSIOR DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537171906",
            "telephone_number": "608-831-1773",
            "fax_number": "608-828-4843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2016-09-30",
        "status": "A",
        "authorized_official_last_name": "FLAGEL DEAN",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "OPERATION COORDINATOR",
        "authorized_official_telephone_number": "608-828-4811",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Managed Care Organization Pharmacy",
            "state": "WI",
            "license": "7386-42",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2108702",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GHC SAUK TRAILS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.