NPIMap

Organization Active NPI

Ascension Wisconsin Pharmacy, Inc.

Doing business as Ascension Rx 1105

  • Community/Retail Pharmacy
  • Franklin, WI
National Provider Identifier
1053587055
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
882842 Issued in WI
Legal business name
ASCENSION WISCONSIN PHARMACY, INC.
Doing business as
Ascension Rx 1105
Practice address
10101 S 27TH St
Room 1005
Franklin, WI 53132-7209
Phone
(414) 325-4740
Fax
(414) 325-4741
NPI assigned
Apr 30, 2008
Last updated
Dec 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kristopher Cyr
Title
Director
Phone
(262) 687-2151

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 882842 WI Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

10101 S 27TH St
Room 1005
Franklin, WI 53132-7209

Mailing address

PO Box 860011
Minneapolis, MN 55486-0011
Phone (414) 325-4740

Other identifiers 2

IdentifierTypeStateIssuer
2111104OtherPK
36228300MedicaidWI

Other names 1

  • Ascension Rx 1105 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110125000518 WI Part B Supplier - Pharmacy 0446255459 11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wauwatosa, WI; Milwaukee, WI; Franklin, WI; Brookfield, WI; Mequon, WI

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Convenant Pharmacy26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

Locations

10101 S 27th St
Rm 1005
Franklin, WI 53132
Phone (414) 325-4740

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734480000000",
    "number": "1053587055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860011",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554860011",
            "telephone_number": "414-325-4740",
            "fax_number": "414-325-4741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 S 27TH ST",
            "address_2": "ROOM 1005",
            "city": "FRANKLIN",
            "state": "WI",
            "postal_code": "531327209",
            "telephone_number": "414-325-4740",
            "fax_number": "414-325-4741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASCENSION WISCONSIN PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-30",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A",
        "authorized_official_last_name": "CYR",
        "authorized_official_first_name": "KRISTOPHER",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "262-687-2151"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "882842",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2111104",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36228300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ascension Rx 1105",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Franklin, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.