Ascension Wisconsin Pharmacy, Inc.
Organization Active NPI Community/Retail Pharmacy · Mequon, WI
NPI 1154894483 · NPPES record last updated Mar 15, 2019
Key facts
- NPI
- 1154894483
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- Legal business name
- ASCENSION WISCONSIN PHARMACY, INC.
- Practice address
- 13133 N Port Washington Rd Ste G101
Mequon, WI 53097-2419 - Phone
- (262) 243-6700
- Fax
- (262) 243-6701
- NPI assigned
- Jan 9, 2019
- Organization subpart
- Yes
- Parent organization (as reported)
- ASCENSION WISCONSIN PHARMACY, INC.
Authorized official
- Name
- Tracy Ann Rogers
- Title
- Coo
- Phone
- (414) 465-3706
Corporate family (same tax ID) 25
National Provider Directory
- Tax ID family
- Convenant Pharmacy
- Part of
- Convenant Pharmacy
Locations
13133 N Port Washington Rd
Ste G101
Mequon, WI 53097
Phone (262) 243-6700
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Yes |
Addresses
Primary practice location
13133 N Port Washington Rd Ste G101
Mequon, WI 53097-2419
Mailing address
5000 W Chambers St RM 115
Milwaukee, WI 53210-1650
Phone (414) 874-1035
Other names
- Ascension Wisconsin Pharmacy #502
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All providers in Mequon, WI · Community/Retail Pharmacy in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 15, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.