Provider Demographics
NPI:1376791020
Name:AURORA HEALTH CARE VENTURES INC.
Entity Type:Organization
Organization Name:AURORA HEALTH CARE VENTURES INC.
Other - Org Name:AURORA VISION CENTER - SUMMIT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:R
Authorized Official - Last Name:PANTEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-803-3266
Mailing Address - Street 1:36500 AURORA DR
Mailing Address - Street 2:SUITE 130
Mailing Address - City:SUMMIT
Mailing Address - State:WI
Mailing Address - Zip Code:53066-4899
Mailing Address - Country:US
Mailing Address - Phone:262-434-7055
Mailing Address - Fax:262-434-7056
Practice Address - Street 1:36500 AURORA DR
Practice Address - Street 2:SUITE 130
Practice Address - City:SUMMIT
Practice Address - State:WI
Practice Address - Zip Code:53066-4899
Practice Address - Country:US
Practice Address - Phone:262-434-7055
Practice Address - Fax:262-434-7056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-07
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38461700Medicaid
1179350014Medicare NSC