Organization
AURORA PHARMACY INC
Active
Other names
AURORA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MARY R PANTEL (BILLING SUPERVISOR)
(920) 803-3266
Entity
Organization
Contact information
Practice address
927 FOND DU LAC AVE, KEWASKUM, WI 53040-9161
(262) 626-4222
(262) 626-2109
Mailing address
927 FOND DU LAC AVE, KEWASKUM, WI 53040-9161
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
7731
WI
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33227600
—
WI
01
—
5124045
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/11/2006
Last updated
12/22/2010
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