# ASCENSION WISCONSIN PHARMACY, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ASCENSION WISCONSIN PHARMACY, INC
- **Other names:** Ascension WI Prescription Center St. Clare's Hospital
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1154812303
- **Legal business name:** ASCENSION WISCONSIN PHARMACY, INC
- **Authorized official:** JONATHAN W SOHN (CFO)
- **Authorized official phone:** (414) 465-3090

## Contact information

- **Practice address:** 3400 MINISTRY PKWY, WESTON, WI 54476-5220
- **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) 874-1035
- **Mailing address fax:** (414) 874-1099

## Taxonomy

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

## Other

- **Enumeration date:** 05/23/2018
- **Last updated:** 09/03/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2177608 | PK | — |
| 05 | — | 33112800 | — | WI |