Provider Demographics
NPI:1558519207
Name:AURORA HEALTH CARE VENTURES INC.
Entity Type:Organization
Organization Name:AURORA HEALTH CARE VENTURES INC.
Other - Org Name:AURORA VISION CENTER - HARTLAND
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 1:600 WALNUT RIDGE DR
Mailing Address - Street 2:SUITE 216
Mailing Address - City:HARTLAND
Mailing Address - State:WI
Mailing Address - Zip Code:53029-9385
Mailing Address - Country:US
Mailing Address - Phone:262-369-6925
Mailing Address - Fax:262-369-6922
Practice Address - Street 1:600 WALNUT RIDGE DR
Practice Address - Street 2:SUITE 216
Practice Address - City:HARTLAND
Practice Address - State:WI
Practice Address - Zip Code:53029-9385
Practice Address - Country:US
Practice Address - Phone:262-369-6925
Practice Address - Fax:262-369-6922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-07
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38461600Medicaid
WI38461600Medicaid