NPIMap

Organization Active NPI

Aurora Health Care Metro, Inc.

Doing business as Aurora Pharmacy #1012

  • Institutional Pharmacy
  • Cudahy, WI
National Provider Identifier
1073547295
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Institutional PharmacyTaxonomy code 3336I0012X
Legal business name
AURORA HEALTH CARE METRO, INC.
Doing business as
Aurora Pharmacy #1012
Practice address
5900 S Lake Dr
Cudahy, WI 53110-3171
Phone
(414) 489-4600
Fax
(414) 489-4603
NPI assigned
Jul 11, 2006
Last updated
Feb 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 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
Institutional Pharmacy 3336I0012X 7485-42 WI
Institutional Pharmacy 3336I0012X NU Primary

Addresses

Primary practice location

5900 S Lake Dr
Cudahy, WI 53110-3171

Mailing address

5900 S Lake Dr
Cudahy, WI 53110-3171

Other identifiers 2

IdentifierTypeStateIssuer
5123574OtherOTHER ID NUMBER-COMMERCIAL NUMBER
1073547295MedicaidWI

Other names 1

  • Aurora Pharmacy #1012 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040202000666 WI Part B Supplier - Mass Immunization (Roster Biller Only) 3577466820 This NPI is an additional NPI on the enrollment
O20091113000325 WI Part B Supplier - Mass Immunization (Roster Biller Only) 8628986536 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cudahy, WI; Milwaukee, WI
O20110531000171 WI DME Supplier - Pharmacy 8628986536 Practice locations: Cudahy, WI

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
St Lukes Medical Center12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Member of 2

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

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Aurora Medical Center Sheboygan CountySheboygan, WI, CCN 520035 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jun 17, 2010
Jun 17, 2010
Aurora West Allis Medical CenterWest Allis, WI, CCN 520139 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jun 17, 2010
Jun 17, 2010
Aurora Medical Center HartfordHartford, WI, CCN 520038 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jun 17, 2010
Jun 17, 2010
Aurora Psychiatric Hospital IncWauwatosa, WI, CCN 524000 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jun 17, 2010
Jun 17, 2010

Owned or controlled facilities with NPI records 7

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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": "1739232000000",
    "number": "1073547295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 S LAKE DR",
            "city": "CUDAHY",
            "state": "WI",
            "postal_code": "531103171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 S LAKE DR",
            "city": "CUDAHY",
            "state": "WI",
            "postal_code": "531103171",
            "telephone_number": "414-489-4600",
            "fax_number": "414-489-4603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AURORA HEALTH CARE METRO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "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": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "WI",
            "license": "7485-42",
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "5123574",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073547295",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aurora Pharmacy #1012",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cudahy, WI

Sources for this page

Verify at the official NPI Registry.