Healthcare Provider Details

I. General information

NPI: 1528366226
Provider Name (Legal Business Name): AURORA ADVANCED HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2011
Last Update Date: 05/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

N8210 STATE ROAD 28
MAYVILLE WI
53050-2126
US

IV. Provider business mailing address

3003 W GOOD HOPE RD
MILWAUKEE WI
53209-2042
US

V. Phone/Fax

Practice location:
  • Phone: 920-387-9175
  • Fax:
Mailing address:
  • Phone: 414-352-3100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateWI

VIII. Authorized Official

Name: EUGENE W MONROE
Title or Position: PRESIDENT
Credential: MD
Phone: 414-352-3100