Medford Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

9018-42 Issued in WI

Legal business name

MEDFORD PHARMACY INC

Doing business as

Medford Pharmacy

Practice address

210 S Main St
Medford, WI 54451-1843

Phone

(715) 748-4477

Fax

(715) 748-5848

NPI assigned

Aug 3, 2010

Last updated

Oct 4, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Paige Wiles

Title

Admin Assistant

Phone

(715) 418-3478

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• MEDFORD PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in WI2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

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

{
    "created_epoch": "1280793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728000000000",
    "number": "1811201742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S MAIN ST",
            "city": "MEDFORD",
            "state": "WI",
            "postal_code": "544511843",
            "telephone_number": "715-748-4477",
            "fax_number": "715-748-5848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S MAIN ST",
            "city": "MEDFORD",
            "state": "WI",
            "postal_code": "544511843",
            "telephone_number": "715-748-4477",
            "fax_number": "715-748-5848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDFORD PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-03",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A",
        "authorized_official_last_name": "WILES",
        "authorized_official_first_name": "PAIGE",
        "authorized_official_title_or_position": "ADMIN ASSISTANT",
        "authorized_official_telephone_number": "715-418-3478"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "9018-42",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5132319",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDFORD PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Faith Majors-Culp
• Katie L Maske, CSAC, ICS-IT
• Wendy R McCune, RN
• Colleen McGee Zolper, M.S. ED.
• Medford Dental Clinic SC
• Medford School District
• Jessica Meier
• Betsy L Meinel, O.D.
• Memorial Health Center
• Memorial Health Center, Inc.

• Community/Retail Pharmacy in Medford, WI
• Providers in Medford, WI by specialty
• Community/Retail Pharmacy in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.