Provider Demographics
NPI:1982897716
Name:UNIVERSITY OF WISCONSIN HOSPITALS AND CLINICS AUTHORITY
Entity Type:Organization
Organization Name:UNIVERSITY OF WISCONSIN HOSPITALS AND CLINICS AUTHORITY
Other - Org Name:UW HEALTH PHARMACY SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KAPLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:608-828-1811
Mailing Address - Street 1:600 HIGHLAND AVE
Mailing Address - Street 2:PHARMACY F6/133
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53792-1530
Mailing Address - Country:US
Mailing Address - Phone:608-263-1290
Mailing Address - Fax:608-263-9424
Practice Address - Street 1:600 HIGHLAND AVE
Practice Address - Street 2:ROOM 1338 MAIL CODE C-150
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53792-1530
Practice Address - Country:US
Practice Address - Phone:608-890-7899
Practice Address - Fax:608-890-8029
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF WISCONSIN HOSPITALS AND CLINICS AUTHORITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8740-042333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI33299200Medicaid
WI8740-042OtherPHARMACY LICENSE NUMBER
WI5130036OtherNCPDP
WIFU0242468OtherDEA
WI0641600014Medicare NSC