# ASCENSION WISCONSIN PHARMACY, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ascension WI Prescription Center St. Mary's Hospital
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104305085
- **Authorized official:** JONATHAN W SOHN (CFO)
- **Authorized official phone:** (414) 465-3090

## Contact information

- **Practice address:** 2251 N SHORE DR, RHINELANDER, WI 54501-6710
- **Practice address phone:** (715) 355-9573
- **Practice address fax:** (715) 355-9579
- **Mailing address:** PO BOX 860011, MINNEAPOLIS, MN 55486-0011
- **Mailing address phone:** (414) 874-1026
- **Mailing address fax:** (414) 874-1099

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 9431-42 | WI | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 08/10/2018
- **Last updated:** 09/03/2019