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
203 N MAIN ST, LAKE MILLS, WI 53551-1610
(920) 648-3455
(920) 648-2712
Mailing address
203 N MAIN ST, LAKE MILLS, WI 53551-1610
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
8406
WI
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33275300
—
WI
01
—
5127938
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/11/2006
Last updated
01/22/2008
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