Provider Demographics
NPI:1861666554
Name:AURORA RETAIL STORES, INC.
Entity Type:Organization
Organization Name:AURORA RETAIL STORES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATIENT FINANCIAL SERVICES MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:THEDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-803-3263
Mailing Address - Street 1:12500 W BLUEMOUND RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ELM GROVE
Mailing Address - State:WI
Mailing Address - Zip Code:53122-2600
Mailing Address - Country:US
Mailing Address - Phone:262-787-2135
Mailing Address - Fax:
Practice Address - Street 1:12500 W BLUEMOUND RD
Practice Address - Street 2:SUITE 201
Practice Address - City:ELM GROVE
Practice Address - State:WI
Practice Address - Zip Code:53122-2600
Practice Address - Country:US
Practice Address - Phone:262-787-2135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies