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Organization
AURORA PHARMACY INC
Active
Organization
AURORA PHARMACY INC
Active
Other names
AURORA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MARY PANTEL (BILLING SUPERVISOR)
(920) 803-3266
Entity
Organization
Contact information
Practice address
6969 N PORT WASHINGTON RD, SUITE B120, GLENDALE, WI 53217-3962
(414) 540-1194
(414) 540-1497
Mailing address
6969 N PORT WASHINGTON RD, SUITE B120, GLENDALE, WI 53217-3962
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
8459
WI
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33280700
—
WI
01
—
5128308
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/11/2006
Last updated
12/22/2010
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