Healthcare Provider Details

I. General information

NPI: 1295769412
Provider Name (Legal Business Name): AURORA PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2253 W MASON ST
GREEN BAY WI
54303-4706
US

IV. Provider business mailing address

2253 W MASON ST
GREEN BAY WI
54303-4706
US

V. Phone/Fax

Practice location:
  • Phone: 920-327-7220
  • Fax: 920-327-7221
Mailing address:
  • Phone: 920-327-7220
  • Fax: 920-327-7221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number9395
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: KARA RICHARDSON
Title or Position: VP MANAGED HEALTH
Credential:
Phone: 704-631-0450