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

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

National Provider Directory

Tax ID family
Convenant Pharmacy (26 organizations share this tax ID)
Part of
Convenant Pharmacy

Locations

13133 N Port Washington Rd
Ste G101
Mequon, WI 53097
Phone (262) 243-6700

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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 Doing business as

Other providers in Mequon, WI

All providers in Mequon, WI · Community/Retail Pharmacy in Wisconsin

Sources for this page

Verify at the official NPI Registry.