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Prohealth Medical Group Inc — NPI 1316752900, Waukesha, WI | NPI Central

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NPI 1316752900

OrganizationActive

Prohealth Medical Group Inc

NPI 1316752900 · Non-Pharmacy Dispensing Site · Waukesha, WI

Provider details

NPI number: 1316752900
Entity type: Organization
Primary specialty: Non-Pharmacy Dispensing SiteSuppliers
Parent organization: Prohealth Medical Group Inc
Organization subpart: Yes
Authorized official: Thomas Johnson, Reimbursement Manager(262) 928-4704

Specialties & taxonomies

Non-Pharmacy Dispensing SitePrimary332900000X
Suppliers

Practice location

N16w24131 Riverwood Dr

Waukesha, WI 53188-1106

Phone: (262) 696-0889

Fax: (262) 696-0922

Approximate (ZIP-level) locationGet directions

More WI providers

Mailing address

N16w24131 Riverwood Dr

Waukesha, WI 53188-1106

Other names (DBA / former)

Doing business as: Pewaukee Medical Oncology
Doing business as: Pewaukee Medical Oncology

Registry dates

Enumerated: 2025-02-11
Last updated: 2025-07-30
Certified: 2025-07-30

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.