# ASCENSION WISCONSIN PHARMACY, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ASCENSION WISCONSIN PHARMACY, INC
- **Other names:** Ascension Rx 1109
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1306042411
- **Legal business name:** ASCENSION WISCONSIN PHARMACY, INC
- **Authorized official:** KRISTOPHER CYR (DIRECTOR)
- **Authorized official phone:** (262) 687-2151

## Contact information

- **Practice address:** 13133 N PORT WASHINGTON RD, SUITE G01, MEQUON, WI 53097-2419
- **Practice address phone:** (262) 243-6700
- **Practice address fax:** (262) 243-6701
- **Mailing address:** 5000 W CHAMBERS ST RM 5223, MILWAUKEE, WI 53210-1650
- **Mailing address phone:** (414) 874-1035
- **Mailing address fax:** (414) 874-1099

## Taxonomy

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

## Other

- **Enumeration date:** 06/25/2007
- **Last updated:** 12/18/2024