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General NPI Number Information
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NPI Number | 1841468428
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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 | 02/15/2008
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Last Update Date | 03/28/2008
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Provider Practice Location Address
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Address Line | 2707 15TH PLACE SUITE 101
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City | KENOSHA
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State | WI
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Zip | 53140
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Country | US
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Telephone | 262-551-2790
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Fax | 262-553-9102
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Provider Business Mailing Address
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Address Line | 2707 15TH PLACE SUITE 101
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City | KENOSHA
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State | WI
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Zip | 53140
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Country | US
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Telephone | 262-551-2790
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Fax | 262-553-9102
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Authorized Official
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Title or Position | PATIENT FINANCIAL SERVICES SUPERVIS
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Name | MARY R PANTEL
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Credential |
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Telephone | 920-803-3266
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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 | 8808
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License Number State | WI
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