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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
1333600000XPharmacy8730WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
25129879OTHERWINCPDP

General Provider Information

NPI Number : 1649309774
Entity Type Code : Organization
Provider Name (Legal Business Name) : AURORA PHARMACY, INC.
Provider Business Mailing Address
First Line : 7300 W DEAN RD
Second Line :
City : MILWAUKEE
State : WI
Zip : 53223-2637
Country : US
Telephone Number : 414-371-7380
Fax Number : 414-371-7525
Provider Business Practice Location Address
First Line : 7300 W DEAN RD
Second Line :
City : MILWAUKEE
State : WI
Zip : 53223-2637
Country : US
Telephone Number : 414-371-7380
Fax Number : 414-371-7525
Authorized Official
Title or Position : BILLING MANAGER
Name : JOANNE THEDE
Credential :
Telephone Number : 920-803-3263
Provider Enumeration Date : 03/05/2007
Last Update Date : 01/25/2008

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