NPIMap

Organization Active NPI

SSM Health Care of Wisconsin, Inc.

Doing business as St Marys Care Center Pharmacy

  • Long Term Care Pharmacy
  • Madison, WI
National Provider Identifier
1407932536
Registry record updated Oct 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
8247-42 Issued in WI
Legal business name
SSM HEALTH CARE OF WISCONSIN, INC.
Doing business as
St Marys Care Center Pharmacy
Practice address
3401 Maple Grove Dr
Madison, WI 53719-5013
Phone
(608) 845-0447
Fax
(608) 845-0449
NPI assigned
Oct 31, 2006
Last updated
Oct 25, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2021

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

Authorized official

Name
Audrey Rufenacht, PHARMD
Title
Pharmacist
Phone
(608) 845-0447

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Long Term Care Pharmacy 3336L0003X 8247-42 WI Primary

Addresses

Primary practice location

3401 Maple Grove Dr
Madison, WI 53719-5013

Mailing address

3401 Maple Grove Dr
Madison, WI 53719-5013
Phone (608) 845-0447

Other identifiers 2

IdentifierTypeStateIssuer
33241000MedicaidWI
2115167OtherPK

Other names 1

  • ST MARYS CARE CENTER PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Rocco J Fiordelisi MD22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635120000000",
    "number": "1407932536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 MAPLE GROVE DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537195013",
            "telephone_number": "608-845-0447",
            "fax_number": "608-845-0449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 MAPLE GROVE DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537195013",
            "telephone_number": "608-845-0447",
            "fax_number": "608-845-0449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSM HEALTH CARE OF WISCONSIN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A",
        "authorized_official_last_name": "RUFENACHT",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "608-845-0447",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "WI",
            "license": "8247-42",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33241000",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2115167",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST MARYS CARE CENTER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ST MARYS CARE CENTER 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 Oct 25, 2021; 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.