Aurora Pharmacy, Inc.
Organization Active NPI Clinic Pharmacy · Waterford, WI
NPI 1679529663 · NPPES record last updated Feb 5, 2026
Key facts
- NPI
- 1679529663
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic Pharmacy 3336C0002X
- License
- 9395 (WI)
- Legal business name
- AURORA PHARMACY, INC.
- Practice address
- 818 Forrest Dr
Suite 101
Waterford, WI 53185-4577 - Phone
- (262) 514-8050
- Fax
- (262) 514-8151
- NPI assigned
- May 25, 2006
- Organization subpart
- No
Authorized official
- Name
- Kara Richardson
- Title
- VP Managed Health
- Phone
- (704) 631-0450
Corporate family (same tax ID) 24
Member of 1
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Aurora Pharmacy #1068 |
Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) | Does not accept assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WI
Medicare enrollment records
| 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 |
| O20100930069377 | WI | DME Supplier - Pharmacy | 3577466820 | Practice locations: Waterford, WI |
National Provider Directory
- Tax ID family
- Aurora Pharmacy
Locations
818 Forest Ln
Ste 101
Waterford, WI 53185
Phone (262) 514-8050
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic Pharmacy | 3336C0002X | 9395 | WI | Yes |
Addresses
Primary practice location
818 Forrest Dr
Suite 101
Waterford, WI 53185-4577
Mailing address
818 Forest LN Ste 101
Waterford, WI 53185-4585
Phone (262) 514-8050
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5129184 | Other | NCPDP | |
| 33288200 | Medicaid | WI | |
| 000086609 | Other | WI | MEDICARE IMMUNIZATION |
Other names
- Aurora Pharmacy #1068
- Aurora Prescription Dispensing Center
Other providers in Waterford, WI
- Rachel Addis
- Cheryl A. Alexander
- Athletico LTD
- Aurora Medical Group, Inc.
- Aurora Medical Group, Inc.
- Avada Audiology and Hearing Care
- Megan Baranek
- Allyson Beyers
- Leah Ann Bolskar
- Leah Marie Borchardt
All providers in Waterford, 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 Feb 5, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.