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
8770 S HOWELL AVE, SUITE 3, OAK CREEK, WI 53154-7524
(414) 762-6770
(414) 571-4125
Mailing address
8770 S HOWELL AVE, SUITE 3, OAK CREEK, WI 53154-7524
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
7627
WI
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000086747
MEDICARE IMMUNIZATION
WI
05
—
33218700
—
WI
01
—
5123269
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/13/2006
Last updated
08/05/2009
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