MEDICARE: TYLER EDLIN PHARMD

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
1	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	26031556A	IN

General Provider Information

NPI Number	:	1689516569
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TYLER EDLIN PHARMD

Provider Business Mailing Address
First Line	:	10450 E WASHINGTON ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46229-2657
Country	:	US
Telephone Number	:	317-895-2247
Fax Number	:

Provider Business Practice Location Address
First Line	:	10450 E WASHINGTON ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46229-2657
Country	:	US
Telephone Number	:	317-895-2247
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2026
Last Update Date	:	04/08/2026

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