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General NPI Number Information
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NPI Number | 1164596607
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Entity Type | Organization
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Legal Business Name | AURORA PHARMACY, INC.
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 12500 W BLUEMOUND RD SUITE 201
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City | ELM GROVE
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State | WI
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Zip | 53122-2600
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Country | US
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Telephone | 262-787-2136
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Fax |
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Provider Business Mailing Address
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Address Line | 12500 W BLUEMOUND RD SUITE 201
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City | ELM GROVE
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State | WI
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Zip | 53122-2600
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Country | US
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Telephone | 262-787-2136
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | VICKI L SOERENS
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Credential |
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Telephone | 920-803-3260
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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