Healthcare Provider Details

I. General information

NPI: 1285128215
Provider Name (Legal Business Name): AURORA PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2018
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3509 DEWEY STREET SUITE 100
MANITOWOC WI
54220
US

IV. Provider business mailing address

2307 S BUSINESS DR
SHEBOYGAN WI
53081-6133
US

V. Phone/Fax

Practice location:
  • Phone: 920-652-3030
  • Fax: 920-652-3035
Mailing address:
  • Phone: 920-803-3266
  • Fax: 920-459-2634

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number9395
License Number StateWI

VIII. Authorized Official

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