Organization Active NPI

Aurora Pharmacy, Inc.

Doing business as Aurora Pharmacy

  • Pharmacy
  • Racine, WI
National Provider Identifier
1902931702
Registry record updated Jan 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
8724 Issued in WI
Legal business name
AURORA PHARMACY, INC.
Doing business as
Aurora Pharmacy
Practice address
5740 Washington Ave
Racine, WI 53406-4018
Phone
(262) 619-1162
Fax
(262) 619-1196
NPI assigned
Feb 22, 2007
Last updated
Jan 25, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Joanne A Thede
Title
Billing Manager
Phone
(920) 803-3263

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 8724 WI Primary

Addresses

Primary practice location

5740 Washington Ave
Racine, WI 53406-4018

Mailing address

5740 Washington Ave
Racine, WI 53406-4018
Phone (262) 619-1162

Other names 1

  • Aurora Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040202000666 WI Part B Supplier - Mass Immunization (Roster Biller Only) 3577466820 This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Locations

5740 Washington Ave
Mount Pleasant, WI 53406
Phone (262) 619-1162

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201219200000",
    "number": "1902931702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5740 WASHINGTON AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534064018",
            "telephone_number": "262-619-1162",
            "fax_number": "262-619-1196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5740 WASHINGTON AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534064018",
            "telephone_number": "262-619-1162",
            "fax_number": "262-619-1196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AURORA PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2008-01-25",
        "status": "A",
        "authorized_official_last_name": "THEDE",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "920-803-3263"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "WI",
            "license": "8724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aurora Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Racine, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.