# WAUKESHA HEALTH SYSTEM, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ProHealth Pharmacy - Waukesha
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073528675
- **Authorized official:** THOMAS W JOHNSON (REIMBURSEMENT MANAGER)
- **Authorized official phone:** (262) 928-4704

## Contact information

- **Practice address:** 725 AMERICAN AVE STE 2309, WAUKESHA, WI 53188-5031
- **Practice address phone:** (262) 928-2279
- **Practice address fax:** (262) 544-0928
- **Mailing address:** 725 AMERICAN AVE, WAUKESHA, WI 53188-5031
- **Mailing address phone:** (262) 928-2279
- **Mailing address fax:** (262) 544-0928

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 669442 | WI | Yes |

## Other

- **Enumeration date:** 07/30/2006
- **Last updated:** 12/14/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2113659 | PK | — |
| 05 | — | 33154500 | — | WI |