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General NPI Number Information
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NPI Number | 1013984194
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Entity Type | Organization
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Legal Business Name | ASCENSION WISCONSIN PHARMACY, INC.
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Dates
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Enumeration Date | 03/07/2006
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 7400 W RAWSON AVE STE 140
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City | FRANKLIN
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State | WI
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Zip | 53132-8281
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Country | US
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Telephone | 414-281-7500
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 860011
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City | MINNEAPOLIS
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State | MN
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Zip | 55486-0011
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Country | US
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Telephone | 414-281-7500
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Fax | 414-282-8610
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Authorized Official
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Title or Position | DIRECTOR
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Name | KRISTOPHER CYR
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Credential |
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Telephone | 262-687-2151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 829242
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License Number State | WI
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