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NPI Code Detail

MEDICARE: AURORA PROFESSIONAL PHARMACY INC

MEDICARE: AURORA PROFESSIONAL PHARMACY INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacy
23336L0003XLong Term Care Pharmacy
33336C0003XCommunity/Retail Pharmacy004661MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12047700OTHERPK
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609865047
Entity Type Code : Organization
Provider Name (Legal Business Name) : AURORA PROFESSIONAL PHARMACY INC
Provider Business Mailing Address
First Line : 124 S MADISON AVE
Second Line :
City : AURORA
State : MO
Zip : 65605-1427
Country : US
Telephone Number : 417-678-4136
Fax Number : 417-678-2014
Provider Business Practice Location Address
First Line : 124 S MADISON AVE
Second Line :
City : AURORA
State : MO
Zip : 65605-1427
Country : US
Telephone Number : 417-678-4136
Fax Number : 417-678-2014
Authorized Official
Title or Position : OWNER
Name : STEPHEN L MCCLANAHAN
Credential :
Telephone Number : 417-735-0055
Provider Enumeration Date : 10/18/2005
Last Update Date : 02/26/2025

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Directions to “AURORA PROFESSIONAL PHARMACY INC ” Practice Location

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