| NPI | 1164090825 |
|---|---|
| Doing Business As | BLUE RIVER PHARMACY |
| Entity Type | Organization |
| Authorized Contact | PAUL CRUZAN President 317-286-3506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2021-06-17 |
| Last Update Date | 2021-06-22 |