Aurora Pharmacy Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

8406 Issued in WI

Legal business name

AURORA PHARMACY INC

Doing business as

AURORA PHARMACY

Practice address

203 N Main St
Lake Mills, WI 53551-1610

Phone

(920) 648-3455

Fax

(920) 648-2712

NPI assigned

Jul 11, 2006

Organization subpart

No

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 2

Addresses

Other identifiers 2

Other names 1

• AURORA PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Member of 1

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

• Aurora Health Care Ventures Inc.

  • Eyewear Supplier
  • Summit, WI
  • NPI 1376791020

  Member Of

  NPD member

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200960000000",
    "number": "1386678506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 N MAIN ST",
            "city": "LAKE MILLS",
            "state": "WI",
            "postal_code": "535511610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 N MAIN ST",
            "city": "LAKE MILLS",
            "state": "WI",
            "postal_code": "535511610",
            "telephone_number": "920-648-3455",
            "fax_number": "920-648-2712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AURORA PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2008-01-22",
        "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": "8406",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33275300",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "5127938",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AURORA PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gregory D Anderson, DC
• Marissa Anderson, DPT, PT
• Leanne Anthon, RN
• Jill Armentrout
• Assisted Living Concepts Inc
• Elizabeth Frances Balsiger, MS, CCC-SLP
• Hannah Baneck
• Jessica Eva Beck, CRNA, APRN
• Jaclyn Benish
• Nicole Lee Berg-Johnson, FNP

• Pharmacy in Lake Mills, WI
• Providers in Lake Mills, WI by specialty
• Pharmacy in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.

Verify at the official NPI Registry.