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PED523300-00 CHILDREN'S HOSPITAL OF WISCONSIN, INC. (Active)
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Main Details
Name
CHILDREN'S HOSPITAL OF WISCONSIN, INC.
Subdivision Name
Type
Children's Hospital
Rural
No
340B ID
PED523300-00
Medicare Provider Number
523300
Additional Details
Current Program Status
Active
Registration Date
3/10/2010
Participating Start Date
4/1/2010
Participating Approval Date
3/11/2010
Last Recertification Date
8/28/2024
Contacts
Authorizing Official
Children's Hospital of Wisconsin
Scott Turner, COO CHW and EVP CHHS
(414) 266-2648
Primary Contact
Children's Wisconsin
Megan Elizabeth Ose, Director of Pharmacy Services
(414) 266-5773
Addresses
Street Address
9000 W. WISCONSIN AVENUE
MILWAUKEE, WI 53226
Billing Address
CHILDREN'S HOSPITAL OF WISCONSIN, INC.
9000 W. WISCONSIN AVENUE
MILWAUKEE, WI 53226
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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