Provider Demographics
NPI:1386068179
Name:AURORA PHARMACY
Entity type:Organization
Organization Name:AURORA PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:920-565-5425
Mailing Address - Street 1:620 S WISCONSIN DR
Mailing Address - Street 2:
Mailing Address - City:HOWARDS GROVE
Mailing Address - State:WI
Mailing Address - Zip Code:53083-1263
Mailing Address - Country:US
Mailing Address - Phone:920-565-5425
Mailing Address - Fax:920-565-4477
Practice Address - Street 1:620 S WISCONSIN DR
Practice Address - Street 2:
Practice Address - City:HOWARDS GROVE
Practice Address - State:WI
Practice Address - Zip Code:53083-1263
Practice Address - Country:US
Practice Address - Phone:920-565-5425
Practice Address - Fax:920-565-4477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-13
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10770183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty