Organization
ASCENSION WISCONSIN PHARMACY, INC
Active
Parent organization
ASCENSION WISCONSIN PHARMACY, INC
Other names
Ascension WI Prescription Center St. Clare's Hospital
Organization subpart
Yes
Provider details
NPI number
Legal business name
ASCENSION WISCONSIN PHARMACY, INC
Authorized official
JONATHAN W SOHN (CFO)
(414) 465-3090
Entity
Organization
Contact information
Practice address
3400 MINISTRY PKWY, WESTON, WI 54476-5220
(715) 355-9573
(715) 355-9579
Mailing address
PO BOX 860011, MINNEAPOLIS, MN 55486-0011
(414) 874-1035
(414) 874-1099
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
9431-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2177608
PK
—
05
—
33112800
—
WI
Enumeration date
05/23/2018
Last updated
09/03/2019
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