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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
1333600000XPharmacy8814WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15130581OTHERNCPDP
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1306017942
Entity Type Code : Organization
Provider Name (Legal Business Name) : AURORA PHARMACY, INC.
Provider Business Mailing Address
First Line : 3003 W GOOD HOPE RD
Second Line : SUITE 1129
City : MILWAUKEE
State : WI
Zip : 53209-2042
Country : US
Telephone Number : 414-540-9236
Fax Number : 414-540-9347
Provider Business Practice Location Address
First Line : 3003 W GOOD HOPE RD
Second Line : SUITE 1129
City : MILWAUKEE
State : WI
Zip : 53209-2042
Country : US
Telephone Number : 414-540-9236
Fax Number : 414-540-9347
Authorized Official
Title or Position : PATIENT FINANCIAL SERVICES SUPERVIS
Name : MARY R PANTEL
Credential :
Telephone Number : 920-803-3266
Provider Enumeration Date : 03/21/2008
Last Update Date : 05/27/2008

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