NPIMap

Organization Active NPI

Aurora Pharmacy Inc

Doing business as Aurora Pharmacy

  • Pharmacy
  • Wautoma, WI
National Provider Identifier
1003840224
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
8450 Issued in WI
Legal business name
AURORA PHARMACY INC
Doing business as
Aurora Pharmacy
Practice address
900 E Division Dr.
Wautoma, WI 54982-6944
Phone
(920) 787-6940
Fax
(920) 787-6945
NPI assigned
Jul 11, 2006
Last updated
Jan 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kara Richardson
Title
VP Managed Health
Phone
(704) 631-0450

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 8450 WI Primary
Community/Retail Pharmacy 3336C0003X NU

Addresses

Primary practice location

900 E Division Dr.
Wautoma, WI 54982-6944

Mailing address

900 E Division Dr.
Wautoma, WI 54982-6944

Other identifiers 2

IdentifierTypeStateIssuer
33278700MedicaidWI
5128233OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • AURORA PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040202000666 WI Part B Supplier - Mass Immunization (Roster Biller Only) 3577466820 This NPI is an additional NPI on the enrollment
O20100930099871 WI DME Supplier - Pharmacy 3577466820 Practice locations: Wautoma, WI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Aurora Pharmacy Inc900 E Division St, Wautoma, WI 54982-6944(920) 787-6940 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Canes and/or Crutches|Walkers|Wheelchair Seating/Cushions|Orthoses: Off-The-Shelf|Ostomy Supplies|Urological Supplie… Does not accept assignmentParticipating since Jan 1, 2002

National Provider Directory

National Provider Directory
Tax ID family
Sinai Samaritan Pharmac112 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 13

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 13

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

900 E Division St
Wautoma, WI 54982
Phone (920) 787-0837

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738195200000",
    "number": "1003840224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 E DIVISION DR.",
            "city": "WAUTOMA",
            "state": "WI",
            "postal_code": "549826944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E DIVISION DR.",
            "city": "WAUTOMA",
            "state": "WI",
            "postal_code": "549826944",
            "telephone_number": "920-787-6940",
            "fax_number": "920-787-6945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AURORA PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "KARA",
        "authorized_official_title_or_position": "VP MANAGED HEALTH",
        "authorized_official_telephone_number": "704-631-0450"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "WI",
            "license": "8450",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33278700",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "5128233",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AURORA PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wautoma, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.