Provider Demographics
NPI:1447521927
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 1:1055 N MAYFAIR RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3436
Mailing Address - Country:US
Mailing Address - Phone:414-479-2500
Mailing Address - Fax:414-479-2505
Practice Address - Street 1:1055 N MAYFAIR RD
Practice Address - Street 2:SUITE 100
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3436
Practice Address - Country:US
Practice Address - Phone:414-479-2500
Practice Address - Fax:414-479-2505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-16
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9408333600000X
WI93953336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5133018OtherNCPDP
WI1447521927Medicaid
5133018OtherNCPDP