Organization
AURORA PHARMACY INC
Active
Other names
AURORA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KARA RICHARDSON (VP MANAGED HEALTH)
(704) 631-0450
Entity
Organization
Contact information
Practice address
10400 75TH ST, KENOSHA, WI 53142-7884
(262) 948-7040
(262) 948-7330
Mailing address
10400 75TH ST, KENOSHA, WI 53142-7884
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
7400
WI
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000086609
MEDICARE IMMUNIZATION
WI
05
—
33201600
—
WI
01
—
5122089
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/11/2006
Last updated
02/04/2025
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