Organization
AURORA PHARMACY INC
Active
Other names
Aurora Pharmacy #1222, Aurora Prescription Dispensing Center
Organization subpart
No
Provider details
NPI number
Authorized official
KARA RICHARDSON (VP MANAGED HEALTH)
(704) 631-0450
Entity
Organization
Contact information
Practice address
313 S MAIN ST, CEDAR GROVE, WI 53013-1611
(920) 668-6286
(920) 668-8171
Mailing address
313 S MAIN ST, CEDAR GROVE, WI 53013-1611
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
9395
WI
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33217300
MEDICAID
WI
01
—
5118016
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/11/2006
Last updated
10/09/2025
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