Active NPI
Aurora Pharmacy Inc
Doing business as Aurora Pharmacy #1174
- Clinic Pharmacy
- Walworth, WI
National Provider Identifier
1962436188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic Pharmacy
- License
- 9395
- Legal business name
- AURORA PHARMACY INC
- Doing business as
- Aurora Pharmacy #1174
Aurora Prescription Dispensing Center - Practice address
- 525 Kenosha St
Suite C
Walworth, WI 53184-9512 - Phone
- (262) 275-0936
- Fax
- (262) 275-0953
- NPI assigned
- Jul 11, 2006
- Last updated
- Oct 1, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mary Pantel
- Title
- Revenue Cycle Analyst Sr
- Phone
- (920) 803-3266
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic Pharmacy | 3336C0002X | 9395 | WI | Primary |
| Community/Retail Pharmacy | 3336C0003X | NU |
Addresses
Primary practice location
525 Kenosha St
Suite C
Walworth, WI 53184-9512
Mailing address
525 Kenosha St Ste C
Walworth, WI 53184-9512
Phone (262) 275-0936
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5125213 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER | |
| 33242100 | Medicaid | WI |
Other names 2
- Aurora Pharmacy #1174
- Aurora Prescription Dispensing Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 2
| 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 |
| O20100930001823 | WI | DME Supplier - Pharmacy | 3577466820 | Practice locations: Walworth, WI |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Aurora Pharmacy Inc | Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Canes and/or Crutches|Walkers|Ostomy Supplies|Urological Supplies|Surgical Dressings | Does not accept assignment |
National Provider Directory
National Provider Directory- Tax ID family
- Sinai Samaritan Pharmac
Organizations with this tax ID in the same state 13
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
- Pharmacy
- Summit, WI
- NPI 1902038565
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
525 Kenosha St
#C
Walworth, WI 53184
Phone (262) 275-0936
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1759276800000",
"number": "1962436188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "525 KENOSHA ST STE C",
"city": "WALWORTH",
"state": "WI",
"postal_code": "531849512",
"telephone_number": "262-275-0936",
"fax_number": "262-275-0953"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 KENOSHA ST",
"address_2": "SUITE C",
"city": "WALWORTH",
"state": "WI",
"postal_code": "531849512",
"telephone_number": "262-275-0936",
"fax_number": "262-275-0953"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AURORA PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-11",
"last_updated": "2025-10-01",
"certification_date": "2025-10-01",
"status": "A",
"authorized_official_last_name": "PANTEL",
"authorized_official_first_name": "MARY",
"authorized_official_title_or_position": "REVENUE CYCLE ANALYST SR",
"authorized_official_telephone_number": "920-803-3266"
},
"taxonomies": [
{
"code": "3336C0002X",
"taxonomy_group": "",
"desc": "Pharmacy, Clinic Pharmacy",
"state": "WI",
"license": "9395",
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "5125213",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "33242100",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Aurora Pharmacy #1174",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Aurora Prescription Dispensing Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Walworth, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.