Provider Demographics
NPI:1407876840
Name:AURORA HEALTH CARE VENTURES INC
Entity Type:Organization
Organization Name:AURORA HEALTH CARE VENTURES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:PANTEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-803-3266
Mailing Address - Street 1:6815 118TH AVE
Mailing Address - Street 2:SUITE 125
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53142-8420
Mailing Address - Country:US
Mailing Address - Phone:262-948-7035
Mailing Address - Fax:262-948-7036
Practice Address - Street 1:6815 118TH AVE
Practice Address - Street 2:SUITE 125
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53142-8420
Practice Address - Country:US
Practice Address - Phone:262-948-7035
Practice Address - Fax:262-948-7036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38451500Medicaid
WI38451500Medicaid