Organization
AURORA PHARMACY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY R PANTEL (PATIENT FINANCIAL SERVICES SUPERVIS)
(920) 803-3266
Entity
Organization
Contact information
Practice address
2707 15TH PLACE, SUITE 101, KENOSHA, WI 53140
(262) 551-2790
(262) 553-9102
Mailing address
2707 15TH PLACE, SUITE 101, KENOSHA, WI 53140
(262) 551-2790
(262) 553-9102
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
8808
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36224500
—
WI
01
—
5130480
NCPDP
—
Enumeration date
02/15/2008
Last updated
03/28/2008
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