# ASCENSION WISCONSIN PHARMACY, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ASCENSION WISCONSIN PHARMACY, INC
- **Other names:** Ascension Rx 1111
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1619453990
- **Legal business name:** ASCENSION WISCONSIN PHARMACY, INC
- **Authorized official:** JONATHAN W SOHN (CFO)
- **Authorized official phone:** (414) 465-3090

## Contact information

- **Practice address:** 1506 S ONEIDA ST, APPLETON, WI 54915-1305
- **Practice address phone:** (920) 831-8467
- **Practice address fax:** (920) 831-8499
- **Mailing address:** PO BOX 860644, MINNEAPOLIS, MN 55486-0644
- **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:** 07/19/2018
- **Last updated:** 08/12/2021