AURORA MEDICAL GROUP INC NPI 1477600849

NPI Information

NPI: 1477600849
Provider Name: AURORA MEDICAL GROUP INC

Doing Business As: AURORA MEDICAL GROUP BROWN COUNTY DIALYSIS

Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
1751 DECKNER AVE
GREEN BAY, WI
ZIP 54302
Phone: (920) 465-0430
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AURORA MEDICAL GROUP INC is an end-stage renal disease (esrd) treatment clinic center in Green Bay, WI. AURORA MEDICAL GROUP INC NPI is 1477600849. The provider is registered as an organization entity type.
The provider Is Doing Business As Aurora Medical Group Brown County Dialysis.

The provider's business location address is:

1751 DECKNER AVE
GREEN BAY, WI
ZIP 54302-630
Phone: (920) 465-0430
Fax: (920) 465-1311

The provider's authorized official is Jeffery Bailet .
The authorized official title is President and has the following contact phone number (414) 647-6322.

The enumeration date for this NPI number is 1/5/2007 and was last updated on 9/22/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	332BD1200X	Durable Medical Equipment & Medical Supplies	Dialysis Equipment & Supplies			No
2	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1477600849	MEDICAID	WISCONSIN
2	522552	MEDICARE OSCAR/CERTIFICATION	WISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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