Aurora Pharmacy Inc
Organization Active NPI Pharmacy · South Milwaukee, WI
NPI 1790719912 · NPPES record last updated Jan 30, 2025
Key facts
- NPI
- 1790719912
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- License
- 8018 (WI)
- Legal business name
- AURORA PHARMACY INC
- Practice address
- 2414 10TH Ave
South Milwaukee, WI 53172-2507 - Phone
- (414) 762-2610
- Fax
- (414) 571-4130
- 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
Member of 1
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 |
| O20100930001820 | WI | DME Supplier - Pharmacy | 3577466820 | Practice locations: South Milwaukee, WI |
National Provider Directory
- Tax ID family
- Aurora Pharmacy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 8018 | WI | Yes |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
2414 10TH Ave
South Milwaukee, WI 53172-2507
Mailing address
2414 10TH Ave
South Milwaukee, WI 53172-2507
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5123788 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER | |
| 33223500 | Medicaid | WI |
Other names
- AURORA PHARMACY
Other providers in South Milwaukee, WI
- Ambulatory Neurological Services, LLC
- Ascension Medical Group - Southeast Wisconsin, Inc.
- Assisted Living Concepts Inc
- Athletico LTD
- Aurora Pharmacy Inc
- Marisol Avalos
- Emily Axt
- Marylisa Ayala
- Saja Badwan
- Tracie Barnes
All providers in South Milwaukee, WI · 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 30, 2025. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.