Aurora Pharmacy Inc

Organization Active NPI Clinic Pharmacy · Green Bay, WI

NPI 1295769412 · NPPES record last updated Oct 1, 2025

Key facts

NPI
1295769412
Entity type
Organization (NPI type 2)
Primary specialty
Clinic Pharmacy 3336C0002X
License
9395 (WI)
Legal business name
AURORA PHARMACY INC
Practice address
2253 W Mason St
Green Bay, WI 54303-4706
Phone
(920) 327-7220
Fax
(920) 327-7221
NPI assigned
Jul 11, 2006
Organization subpart
No

Authorized official

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

Corporate family (same tax ID) 24

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

Member of 1

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

Laboratory certificates & supplier records

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

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Aurora Pharmacy #1141
2253 W Mason St, Green Bay, WI 54303-4706 · (920) 327-7220
Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) Does not accept assignment
Participating since Jan 1, 2002

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100930080156 WI DME Supplier - Pharmacy 3577466820 Practice locations: Green Bay, WI

National Provider Directory

Tax ID family
Aurora Pharmacy (112 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X 9395 WI Yes
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

2253 W Mason St
Green Bay, WI 54303-4706

Mailing address

2253 W Mason St
Green Bay, WI 54303-4706
Phone (920) 327-7220

Other identifiers

IdentifierTypeStateIssuer
5127077OtherOTHER ID NUMBER-COMMERCIAL NUMBER
33264000MedicaidWI

Other names

  • Aurora Pharmacy #1141 Doing business as
  • Aurora Prescription Dispensing Center Doing business as

Other providers in Green Bay, WI

All providers in Green Bay, WI · Clinic Pharmacy in Wisconsin

Sources for this page

Verify at the official NPI Registry.