Healthcare Provider Details

I. General information

NPI: 1043434772
Provider Name (Legal Business Name): AURORA MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 KILEY WAY
PLYMOUTH WI
53073-5020
US

IV. Provider business mailing address

2600 KILEY WAY
PLYMOUTH WI
53073-5020
US

V. Phone/Fax

Practice location:
  • Phone: 920-449-7000
  • Fax:
Mailing address:
  • Phone: 920-449-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KARA RICHARDSON
Title or Position: ASSISTANT TREASURER
Credential:
Phone: 704-631-0450