Healthcare Provider Details

I. General information

NPI: 1669581872
Provider Name (Legal Business Name): AURORA PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 01/30/2025
Certification Date: 01/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1061 E COMMERCE BLVD SUITE 100
SLINGER WI
53086-9326
US

IV. Provider business mailing address

1061 E COMMERCE BLVD SUITE 100
SLINGER WI
53086-9326
US

V. Phone/Fax

Practice location:
  • Phone: 262-644-5246
  • Fax: 262-644-9779
Mailing address:
  • Phone: 262-644-5246
  • Fax: 262-644-9779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number9447
License Number StateWI

VIII. Authorized Official

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