Provider Demographics
NPI:1518624840
Name:AURORA PHARMACY INC.
Entity Type:Organization
Organization Name:AURORA PHARMACY INC.
Other - Org Name:AURORA PHARMACY #1433
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EVP FINANCIAL OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:NAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-299-1610
Mailing Address - Street 1:13250 WASHINGTON AVE STE 1A0043
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:WI
Mailing Address - Zip Code:53177-1516
Mailing Address - Country:US
Mailing Address - Phone:262-799-8400
Mailing Address - Fax:262-799-8401
Practice Address - Street 1:13250 WASHINGTON AVE STE 1A0043
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:WI
Practice Address - Zip Code:53177-1516
Practice Address - Country:US
Practice Address - Phone:262-799-8400
Practice Address - Fax:262-799-8401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
No333600000XSuppliersPharmacy