Phillips Roche a Cri Clinic Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

8465-42 Issued in WI

Legal business name

PHILLIPS ROCHE A CRI CLINIC PHARMACY INC

Doing business as

PHILLIPS ROCHE A CRI PHARMACY INC

Practice address

402 W Lake St
Friendship, WI 53934-9699

Phone

(608) 339-9080

Fax

(608) 339-3023

NPI assigned

Jan 31, 2006

Organization subpart

No

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

(608) 847-5949

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• PHILLIPS ROCHE A CRI PHARMACY INC Doing business as

Practitioners 1

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

• Wayne Macardy, RPH

  • Pharmacist
  • Mauston, WI
  • NPI 1649440124
  NPD Authorized official

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490659200000",
    "number": "1841261302",
    "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": "402 W LAKE ST",
            "city": "FRIENDSHIP",
            "state": "WI",
            "postal_code": "539349699",
            "telephone_number": "608-339-9080",
            "fax_number": "608-339-3023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLIPS ROCHE A CRI CLINIC PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-31",
        "last_updated": "2017-03-28",
        "status": "A",
        "authorized_official_last_name": "MACARDY",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "608-847-5949",
        "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": "8465-42",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2115259",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33187500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHILLIPS ROCHE A CRI PHARMACY INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Thao TP Nguyen, DO
• Linda L Noble, CSAC, ICADC
• Sheryl J. Obernberger, NP
• Stephen Charles Paulk, MD
• Jennifer Pavloski, AP SOCIAL WORKER
• R & J Medical Transportation Inc
• Jon D Rawling, MD
• Roche a Cri Clinic SC
• Richie-Ann Soriano Rodriguez, MD
• Sarah Ross, SAC-IT

• Community/Retail Pharmacy in Friendship, WI
• Providers in Friendship, 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 Mar 28, 2017; 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.