| NPI | 1407919806 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN OROURKE President 317-616-4500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336M0002X Pharmacy Mail Order Pharmacy (Licence: IN 1533517) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: IN 60066059A) |
| 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: IN 1533517) | |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2023-12-18 |