MEDICARE: AURORA HEALTH CARE VENTURES 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
1	332H00000X	Eyewear Supplier

Other Identifiers

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

General Provider Information

NPI Number	:	1407876840
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AURORA HEALTH CARE VENTURES INC

Provider Business Mailing Address
First Line	:	6815 118TH AVE
Second Line	:	SUITE 125
City	:	KENOSHA
State	:	WI
Zip	:	53142-8420
Country	:	US
Telephone Number	:	262-948-7035
Fax Number	:	262-948-7036

Provider Business Practice Location Address
First Line	:	6815 118TH AVE
Second Line	:	SUITE 125
City	:	KENOSHA
State	:	WI
Zip	:	53142-8420
Country	:	US
Telephone Number	:	262-948-7035
Fax Number	:	262-948-7036

Authorized Official
Title or Position	:	VP MANAGED HEALTH
Name	:	KARA RICHARDSON
Credential	:
Telephone Number	:	704-631-0450

Provider Enumeration Date	:	07/20/2006
Last Update Date	:	02/24/2025

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