NPIMap

Organization Active NPI

MBMC Mauston Phillips, LLC

Doing business as Mile Bluff Pharmacy - New Lisbon

  • Community/Retail Pharmacy
  • New Lisbon, WI
National Provider Identifier
1770433864
Registry record updated Jan 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
MBMC MAUSTON PHILLIPS, LLC
Doing business as
Mile Bluff Pharmacy - New Lisbon
Practice address
901 W Bridge St
New Lisbon, WI 53950-1083
Phone
(608) 562-3302
NPI assigned
Jan 29, 2026
Organization subpart
Yes
Parent organization
MBMC MAUSTON PHILLIPS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 29, 2026

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

Authorized official

Name
Tom Kaminski
Title
VP - Cfo
Phone
(608) 847-1452

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

901 W Bridge St
New Lisbon, WI 53950-1083

Mailing address

901 W Bridge St
New Lisbon, WI 53950-1083
Phone (608) 562-3302

Other names 1

  • Mile Bluff Pharmacy - New Lisbon Doing business as

National Provider Directory

National Provider Directory
Tax ID family
MBMC Mauston Phillips LLC3 organizations share this tax ID, including this one
Part of
MBMC Mauston Phillips LLC

Other organizations with this tax ID 2

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1769644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769644800000",
    "number": "1770433864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 W BRIDGE ST",
            "city": "NEW LISBON",
            "state": "WI",
            "postal_code": "539501083",
            "telephone_number": "608-562-3302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W BRIDGE ST",
            "city": "NEW LISBON",
            "state": "WI",
            "postal_code": "539501083",
            "telephone_number": "608-562-3302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MBMC MAUSTON PHILLIPS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MBMC MAUSTON PHILLIPS, LLC",
        "enumeration_date": "2026-01-29",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A",
        "authorized_official_last_name": "KAMINSKI",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "VP - CFO",
        "authorized_official_telephone_number": "608-847-1452"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mile Bluff Pharmacy - New Lisbon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Lisbon, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2026; 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.