Organization
ASCENSION WISCONSIN PHARMACY, INC.
Active
Parent organization
ASCENSION WISCONSIN PHARMACY, INC.
Other names
Ascension Wisconsin Pharmacy #501
Organization subpart
Yes
Provider details
NPI number
Legal business name
ASCENSION WISCONSIN PHARMACY, INC.
Authorized official
TRACY ANN ROGERS (COO)
(414) 465-3706
Entity
Organization
Contact information
Practice address
2301 N LAKE DR, MILWAUKEE, WI 53211-4508
(414) 585-1303
(414) 585-2809
Mailing address
2301 N LAKE DR, MILWAUKEE, WI 53211-4508
(414) 585-1303
(414) 585-2809
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9543-42
STATE PHARMACY LICENSE
WI
Enumeration date
01/09/2019
Last updated
03/15/2019
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