OrganizationActive
Source One Healthcare a Division of Phillips Pharmacies
NPI 1205997517 · Health Maintenance Organization · Mauston, WI
Provider details
- NPI number
- 1205997517
- Entity type
- Organization
- Primary specialty
- Health Maintenance OrganizationManaged Care Organizations
- Parent organization
- Phillips Drug Store Inc.
- Organization subpart
- Yes
- Authorized official
- Wayne Macardy, President(800) 779-1276
Specialties & taxonomies
Managed Care Organizations
Practice location
123 E State St
Mauston, WI 53948-1344
Phone: (800) 779-1276
Fax: (608) 847-5739
Approximate (ZIP-level) locationGet directions
Mailing address
123 E State St
Mauston, WI 53948-1344
Other names (DBA / former)
- Other name
- Sourceone Healthcare
Registry dates
- Enumerated
- 2006-12-12
- Last updated
- 2007-11-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.