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NPI Code Detail

MEDICARE: AURORA PHARMACY INC

MEDICARE: AURORA PHARMACY INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336C0003XCommunity/Retail Pharmacy
2333600000XPharmacy7652WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15123497OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255365474
Entity Type Code : Organization
Provider Name (Legal Business Name) : AURORA PHARMACY INC
Provider Business Mailing Address
First Line : 1881 CHICAGO ST
Second Line :
City : DE PERE
State : WI
Zip : 54115-3770
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1881 CHICAGO ST
Second Line :
City : DE PERE
State : WI
Zip : 54115-3770
Country : US
Telephone Number : 920-403-8050
Fax Number : 920-403-8206
Authorized Official
Title or Position : VP MANAGED HEALTH
Name : KARA RICHARDSON
Credential :
Telephone Number : 704-631-0450
Provider Enumeration Date : 07/11/2006
Last Update Date : 01/30/2025

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Directions to “AURORA PHARMACY INC ” Practice Location

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