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General NPI Number Information
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NPI Number | 1073528675
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Entity Type | Organization
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Legal Business Name | WAUKESHA HEALTH SYSTEM, INC
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 12/14/2022
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Provider Practice Location Address
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Address Line | 725 AMERICAN AVE STE 2309
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City | WAUKESHA
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State | WI
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Zip | 53188-5031
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Country | US
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Telephone | 262-928-2279
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Fax | 262-544-0928
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Provider Business Mailing Address
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Address Line | 725 AMERICAN AVE
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City | WAUKESHA
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State | WI
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Zip | 53188-5031
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Country | US
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Telephone | 262-928-2279
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Fax | 262-544-0928
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Authorized Official
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Title or Position | REIMBURSEMENT MANAGER
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Name | THOMAS W JOHNSON
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Credential |
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Telephone | 262-928-4704
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 669442
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License Number State | WI
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