Organization
MERCY HEALTH SYSTEM CORPORATION
Active
Parent organization
MERCY HEALTH SYSTEM
Other names
MERCY WALWORTH PHARMACY
Organization subpart
Yes
Provider details
NPI number
Legal business name
MERCY HEALTH SYSTEM
Authorized official
DON JANCZAK PHARMD (DIRECTOR OF PHARMACY)
(608) 756-6664
Entity
Organization
Contact information
Practice address
N2950 STATE ROAD 67, LAKE GENEVA, WI 53147-2655
(262) 245-2319
(262) 245-4995
Mailing address
1010 N WASHINGTON ST, JANESVILLE, WI 53548-1561
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
8097
WI
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33257100
—
WI
01
—
5126570
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
06/24/2006
Last updated
09/27/2023
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