Provider Demographics
NPI:1972524718
Name:AURORA HEALTH CARE VENTURES, INC.
Entity Type:Organization
Organization Name:AURORA HEALTH CARE VENTURES, INC.
Other - Org Name:AURORA VISION CENTER TWO RIVERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP
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 1:5300 MEMORIAL DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TWO RIVERS
Mailing Address - State:WI
Mailing Address - Zip Code:54241-3923
Mailing Address - Country:US
Mailing Address - Phone:920-793-7515
Mailing Address - Fax:920-793-7516
Practice Address - Street 1:5300 MEMORIAL DR
Practice Address - Street 2:SUITE 200
Practice Address - City:TWO RIVERS
Practice Address - State:WI
Practice Address - Zip Code:54241-3923
Practice Address - Country:US
Practice Address - Phone:920-793-7515
Practice Address - Fax:920-793-7516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38457200Medicaid
WI1179350004Medicare NSC