NPIMap

Organization Active NPI

Phillips Tomah Pharmacy Inc

  • Community/Retail Pharmacy
  • Tomah, WI
National Provider Identifier
1447222799
Registry record updated Jul 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
7805-42 Issued in WI
Legal business name
PHILLIPS TOMAH PHARMACY INC
Doing business as
PHILLIPS TOMAH PHARMACY INC
Practice address
1004 Superior Ave
Tomah, WI 54660-2002
Phone
(608) 372-4115
Fax
(608) 372-4116
NPI assigned
Feb 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2018

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

Authorized official

Name
Wayne Macardy, RPHNPI 1649440124
Title
President
Phone
(800) 343-3784

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 7805-42 WI Primary

Addresses

Primary practice location

1004 Superior Ave
Tomah, WI 54660-2002

Mailing address

PO Box 136
Mauston, WI 53948-0136
Phone (800) 343-3784

Other identifiers 2

IdentifierTypeStateIssuer
2113172OtherPK
33234400MedicaidWI

Other names 1

  • PHILLIPS TOMAH PHARMACY INC Doing business as

National Provider Directory

National Provider Directory

Locations

1004 Superior Ave
Tomah, WI 54660
Phone (608) 372-4115

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1447222799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 136",
            "city": "MAUSTON",
            "state": "WI",
            "postal_code": "539480136",
            "telephone_number": "800-343-3784",
            "fax_number": "608-847-5004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 SUPERIOR AVE",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "546602002",
            "telephone_number": "608-372-4115",
            "fax_number": "608-372-4116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLIPS TOMAH PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-02",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "MACARDY",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "800-343-3784",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "7805-42",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2113172",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33234400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHILLIPS TOMAH PHARMACY INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tomah, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; 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.