Ascension Rx 1104

LBN: Ascension Wisconsin Pharmacy, Inc.
Ascension Rx 1104 is an health care organization with primary practice located at 19333 W North Ave Suite 390, Brookfield WI 53045-4132. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Ascension Wisconsin Pharmacy, Inc. can be contacted via phone (262) 780-4430, or through Sohn, Jonathan W via phone (414) 465-3090.

Contact Information

Primary practice address
19333 W North Ave Suite 390 Brookfield WI 53045-4132
Phone: (262) 780-4430
Fax: (262) 780-4440
Website:
Map and Directions
Authorized official contact:
Name: Sohn, Jonathan W
Phone: (414) 465-3090

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 846242 Wisconsin
Suppliers / Compounding Pharmacy 3336C0004X

Profile Details

NPI number 1114994209
LBN Legal business name Ascension Wisconsin Pharmacy, Inc.
DBA Doing business as Ascension Rx 1104
Authorized official Sohn, Jonathan W
Entity Organization
Organization subpart 1 No
Enumeration date Mar 7th, 2006
Last updated Aug 10th, 2021 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114994209 NPPES
Other 2110236 PK
MEDICAID 33280000 PK

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