=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255683462
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AURORA PHARMACY INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/11/2012
-----------------------------------------------------
Last Update Date | 10/09/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | S68W15500 JANESVILLE RD SUITE 100
-----------------------------------------------------
City | MUSKEGO
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53150-2613
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 414-422-4257
-----------------------------------------------------
Fax | 414-422-4258
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | S68W15500 JANESVILLE RD STE 100
-----------------------------------------------------
City | MUSKEGO
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53150-2613
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 414-422-4257
-----------------------------------------------------
Fax | 414-422-4258
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VP MANAGED HEALTH
-----------------------------------------------------
Name | KARA RICHARDSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 704-631-0450
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0002X
-----------------------------------------------------
Taxonomy Name | Clinic Pharmacy
-----------------------------------------------------
License Number | 9395
-----------------------------------------------------
License Number State | WI
-----------------------------------------------------