Active NPI
Aurora Pharmacy, Inc.
- Pharmacy
- Milwaukee, WI
National Provider Identifier
1124153929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 8727
- Legal business name
- AURORA PHARMACY, INC.
- Practice address
- 123 W Oklahoma Ave
Milwaukee, WI 53207-2640 - Phone
- (414) 482-2406
- Fax
- (414) 482-2904
- NPI assigned
- Feb 22, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Joanne Thede
- Title
- Billing Manager
- Phone
- (920) 803-3263
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 8727 | WI | Primary |
Addresses
Primary practice location
123 W Oklahoma Ave
Milwaukee, WI 53207-2640
Mailing address
123 W Oklahoma Ave
Milwaukee, WI 53207-2640
Phone (414) 482-2406
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33297200 | Medicaid | WI | |
| 5129843 | Other | WI | NCPDP |
Other names 1
- Aurora Pharmacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040202000666 | WI | Part B Supplier - Mass Immunization (Roster Biller Only) | 3577466820 | This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172102400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1201219200000",
"number": "1124153929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "123 W OKLAHOMA AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532072640",
"telephone_number": "414-482-2406",
"fax_number": "414-482-2904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 W OKLAHOMA AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532072640",
"telephone_number": "414-482-2406",
"fax_number": "414-482-2904"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AURORA PHARMACY, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-22",
"last_updated": "2008-01-25",
"status": "A",
"authorized_official_last_name": "THEDE",
"authorized_official_first_name": "JOANNE",
"authorized_official_title_or_position": "BILLING MANAGER",
"authorized_official_telephone_number": "920-803-3263"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "WI",
"license": "8727",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "33297200",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "5129843",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Aurora Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.