Provider Demographics
NPI:1669581872
Name:AURORA PHARMACY, INC.
Entity type:Organization
Organization Name:AURORA PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP MANAGED HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:KARA
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-631-0450
Mailing Address - Street 1:1061 E COMMERCE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SLINGER
Mailing Address - State:WI
Mailing Address - Zip Code:53086-9326
Mailing Address - Country:US
Mailing Address - Phone:262-644-5246
Mailing Address - Fax:262-644-9779
Practice Address - Street 1:1061 E COMMERCE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:SLINGER
Practice Address - State:WI
Practice Address - Zip Code:53086-9326
Practice Address - Country:US
Practice Address - Phone:262-644-5246
Practice Address - Fax:262-644-9779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9447333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI5125263OtherNCPDP
WI33242500Medicaid
WI5125263OtherNCPDP
WI33242500Medicaid