Organization
ASCENSION WISCONSIN PHARMACY, INC.
Active
Other names
Ascension Rx 1107
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTOPHER CYR (DIRECTOR)
(262) 687-2151
Entity
Organization
Contact information
Practice address
3237 S 16TH ST, ROOM 121, MILWAUKEE, WI 53215-4526
(414) 647-5300
(414) 647-5304
Mailing address
PO BOX 860011, MINNEAPOLIS, MN 55486-0011
(414) 647-5300
(414) 647-5304
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
869642
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2111001
PK
—
05
—
33294300
—
WI
Enumeration date
12/01/2006
Last updated
12/18/2024
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