Provider Demographics
NPI:1437170206
Name:AURORA HEALTH CARE VENTURES
Entity Type:Organization
Organization Name:AURORA HEALTH CARE VENTURES
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 1:1001 SERVICE RD
Mailing Address - Street 2:
Mailing Address - City:KIEL
Mailing Address - State:WI
Mailing Address - Zip Code:53042-1295
Mailing Address - Country:US
Mailing Address - Phone:920-894-1025
Mailing Address - Fax:920-894-1026
Practice Address - Street 1:1001 SERVICE RD
Practice Address - Street 2:
Practice Address - City:KIEL
Practice Address - State:WI
Practice Address - Zip Code:53042-1295
Practice Address - Country:US
Practice Address - Phone:920-894-1025
Practice Address - Fax:920-894-1026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38457300Medicaid
WI38457300Medicaid