| NPI | 1790111680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD COX Mnager Outpatient Pharmacy 317-880-4340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy Clinic Pharmacy (Licence: IN 60006350A) |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2013-09-24 |
| Last Update Date | 2024-07-03 |