# ASCENSION WISCONSIN PHARMACY, INC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ASCENSION WISCONSIN PHARMACY, INC.
- **Other names:** Ascension Wisconsin Pharmacy \#501
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1700359031
- **Legal business name:** ASCENSION WISCONSIN PHARMACY, INC.
- **Authorized official:** TRACY ANN ROGERS (COO)
- **Authorized official phone:** (414) 465-3706

## Contact information

- **Practice address:** 2301 N LAKE DR, MILWAUKEE, WI 53211-4508
- **Practice address phone:** (414) 585-1303
- **Practice address fax:** (414) 585-2809
- **Mailing address:** 2301 N LAKE DR, MILWAUKEE, WI 53211-4508
- **Mailing address phone:** (414) 585-1303
- **Mailing address fax:** (414) 585-2809

## Taxonomy

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

## Other

- **Enumeration date:** 01/09/2019
- **Last updated:** 03/15/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 9543-42 | STATE PHARMACY LICENSE | WI |