NPIMap

Organization Active NPI

Ascension Wisconsin Pharmacy, Inc.

Doing business as Ascension Rx 704

  • Community/Retail Pharmacy
  • Rhinelander, WI
National Provider Identifier
1477024479
Registry record updated Oct 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
ASCENSION WISCONSIN PHARMACY, INC.
Doing business as
Ascension Rx 704
Practice address
2251 N Shore Dr
Rhinelander, WI 54501-6710
Phone
(715) 361-4770
Fax
(715) 361-2010
NPI assigned
Dec 17, 2018
Last updated
Oct 12, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2020

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

Authorized official

Name
Jonathan W Sohn
Title
Cfo
Phone
(414) 465-3090

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

2251 N Shore Dr
Rhinelander, WI 54501-6710

Mailing address

5000 W Chambers St RM 5223
Milwaukee, WI 53210-1650
Phone (414) 874-1035

Other names 1

  • Ascension Rx 704 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

NPI Registry JSON

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

{
    "created_epoch": "1545004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602460800000",
    "number": "1477024479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 W CHAMBERS ST RM 5223",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532101650",
            "telephone_number": "414-874-1035",
            "fax_number": "414-874-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2251 N SHORE DR",
            "city": "RHINELANDER",
            "state": "WI",
            "postal_code": "545016710",
            "telephone_number": "715-361-4770",
            "fax_number": "715-361-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASCENSION WISCONSIN PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-17",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A",
        "authorized_official_last_name": "SOHN",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "414-465-3090"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ascension Rx 704",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rhinelander, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2020; 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.