Organization
ASCENSION WISCONSIN PHARMACY, INC.
Active
Other names
Ascension Rx 1103
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTOPHER CYR (DIRECTOR)
(262) 687-2151
Entity
Organization
Contact information
Practice address
5000 W CHAMBERS ST, RM 1801, MILWAUKEE, WI 53210-1650
(414) 447-2585
(414) 447-2592
Mailing address
PO BOX 860011, MINNEAPOLIS, MN 55486-0011
(414) 447-2585
(414) 447-2592
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
8341-42
WI
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2110093
PK
—
05
—
33270900
—
WI
Enumeration date
03/07/2006
Last updated
12/18/2024
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