=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982295390
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AURORA PHARMACY INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/28/2021
-----------------------------------------------------
Last Update Date | 10/10/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 318 E COLLEGE ST STE 102
-----------------------------------------------------
City | DICKSON
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37055-1832
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-682-8472
-----------------------------------------------------
Fax | 615-988-6790
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 640
-----------------------------------------------------
City | BRASELTON
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30517-0011
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-682-8472
-----------------------------------------------------
Fax | 615-988-6790
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | SYLVIA LIND
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 615-682-8472
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336H0001X
-----------------------------------------------------
Taxonomy Name | Home Infusion Therapy Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------