Aurora Pharmacy, Inc.
Organization Active NPI Clinic Pharmacy · Campbellsport, WI
NPI 1639237019 · NPPES record last updated Jan 23, 2008
Key facts
- NPI
- 1639237019
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic Pharmacy 3336C0002X
- License
- 8697 (WI)
- Legal business name
- AURORA PHARMACY, INC.
- Practice address
- 470 Grand View Avenue
Suite 1
Campbellsport, WI 53010 - Phone
- (920) 533-3970
- Fax
- (920) 533-3971
- NPI assigned
- Dec 5, 2006
- Organization subpart
- No
Authorized official
- Name
- Joanne Thede
- Title
- Billing Manager
- Phone
- (920) 803-3263
Corporate family (same tax ID) 24
National Provider Directory
- Tax ID family
- Aurora Pharmacy
Locations
470 Grandview Ave
Ste 1
Campbellsport, WI 53010
Phone (920) 533-3970
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic Pharmacy | 3336C0002X | 8697 | WI | Yes |
Addresses
Primary practice location
470 Grand View Avenue
Suite 1
Campbellsport, WI 53010
Mailing address
470 Grand View Avenue
Suite 1
Campbellsport, WI 53010
Phone (920) 533-3970
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33294100 | Medicaid | WI | |
| 5129615 | Other | WI | NCPDP |
Other names
- Aurora Pharmacy
Other providers in Campbellsport, WI
- Agnesian Healthcare Inc
- Ashley Zimdahl
- Campbellsport Family Dentistry, LLC
- Campbellsport School District
- Consultants Laboratory of Wisconsin, LLC
- David a. Krebs
- Kathleen Diane Depies
All providers in Campbellsport, WI · Clinic Pharmacy in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.