Provider Demographics
NPI:1578109161
Name:AURORA PHARMACY INC
Entity Type:Organization
Organization Name:AURORA PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SVP OF 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:414-299-1659
Mailing Address - Street 1:2307 S BUSINESS DR
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081-6133
Mailing Address - Country:US
Mailing Address - Phone:920-803-3266
Mailing Address - Fax:920-459-2634
Practice Address - Street 1:N93W14575 WHITTAKER WAY STE 201
Practice Address - Street 2:
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051-1652
Practice Address - Country:US
Practice Address - Phone:262-250-6900
Practice Address - Fax:262-250-6910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-19
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy