# PROHEALTH MEDICAL GROUP INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PROHEALTH MEDICAL GROUP INC
- **Other names:** Pewaukee Medical Oncology
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1316752900
- **Legal business name:** PROHEALTH MEDICAL GROUP INC
- **Authorized official:** THOMAS W JOHNSON (REIMBURSEMENT MANAGER)
- **Authorized official phone:** (262) 928-4704

## Contact information

- **Practice address:** N16W24131 RIVERWOOD DR, WAUKESHA, WI 53188-1106
- **Practice address phone:** (262) 696-0889
- **Practice address fax:** (262) 696-0922
- **Mailing address:** N16W24131 RIVERWOOD DR, WAUKESHA, WI 53188-1106

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332900000X | Non-Pharmacy Dispensing Site | — | NULL | Yes |

## Other

- **Enumeration date:** 02/11/2025
- **Last updated:** 07/30/2025