Organization
WAUKESHA HEALTH SYSTEM, INC
Active
Other names
ProHealth Pharmacy - Waukesha
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS W JOHNSON (REIMBURSEMENT MANAGER)
(262) 928-4704
Entity
Organization
Contact information
Practice address
725 AMERICAN AVE STE 2309, WAUKESHA, WI 53188-5031
(262) 928-2279
(262) 544-0928
Mailing address
725 AMERICAN AVE, WAUKESHA, WI 53188-5031
(262) 928-2279
(262) 544-0928
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
669442
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2113659
PK
—
05
—
33154500
—
WI
Enumeration date
07/30/2006
Last updated
12/14/2022
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