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NPI Code Detail

MEDICARE: ELIZABETH DEGROFF RPH

MEDICARE:   ELIZABETH  DEGROFF  RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist26021139AIN

General Provider Information

NPI Number : 1639778285
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH DEGROFF RPH
Provider Business Mailing Address
First Line : 8970 COVINGTON BLVD
Second Line :
City : FISHERS
State : IN
Zip : 46037-9451
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4650 S EMERSON AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46203-5932
Country : US
Telephone Number : 317-783-1484
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2020
Last Update Date : 10/23/2020

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