Organization
AURORA PHARMACY, INC
Active
Other names
Aurora Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JOANNE THEDE (BILLING MANAGER)
(920) 803-3263
Entity
Organization
Contact information
Practice address
7014 GREEN BAY RD, KENOSHA, WI 53142-1435
(262) 697-8615
(262) 697-8698
Mailing address
7014 GREEN BAY RD, KENOSHA, WI 53142-1435
(262) 697-8615
(262) 697-8698
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
8726
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33297500
—
WI
01
—
5129831
NCPDP
WI
Enumeration date
02/22/2007
Last updated
01/25/2008
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