Pharmacy Details

MBMC MAUSTON PHILLIPS, LLC - information as of 5/20/2025 2:15:33 AM

Name
MBMC MAUSTON PHILLIPS, LLC

Address

MILE BLUFF PHARMACY, DBA
406 GATEWAY AVE
MAUSTON, WI 53948

Comments

Contracts
History

Contracts

Contract Detail	340B ID	Entity Name	Sub Name	Entity Type	Address	Address Cont.	City	State	Begin Date	Term Date	Edit Date
Details	SCH520109-00	MILE BLUFF MEDICAL CENTER INC.		Sole Community Hospital	1050 DIVISION STREET		Mauston	WI	04/01/2017	02/01/2024	2/13/2024 11:19 AM

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Addresses	Pharmacy Address	Update		MBMC MAUSTON PHILLIPS, LLC MBMC MAUSTON PHILLIPS, LLC 123 E STATE ST MAUSTON, WI 53948	MBMC MAUSTON PHILLIPS, LLC MILE BLUFF PHARMACY, DBA 406 GATEWAY AVE MAUSTON, WI 53948	3/21/2025 2:36 PM
Addresses	Pharmacy Address	Update		MBMC MAUSTON PHILLIPS, LLC PHILLIPS PHARMACY 123 E STATE ST MAUSTON, WI 53948-1344	MBMC MAUSTON PHILLIPS, LLC MBMC MAUSTON PHILLIPS, LLC 123 E STATE ST MAUSTON, WI 53948	3/3/2025 10:15 AM
Addresses	Pharmacy Address	Insert			MBMC MAUSTON PHILLIPS, LLC PHILLIPS PHARMACY 123 E STATE ST MAUSTON, WI 53948-1344	12/19/2019 2:14 PM
Details	Comments	Insert				11/30/2016 3:39 PM
Details	Is Deleted	Insert			False	11/30/2016 3:39 PM
Addresses	Pharmacy Address	Insert			MBMC MAUSTON PHILLIPS, LLC PHILLIPS PHARMACY 123 E. STATE STREET MAUSTON, WI 53948-1344	11/30/2016 3:39 PM
Details	Name	Insert			MBMC MAUSTON PHILLIPS, LLC	11/30/2016 3:39 PM