Healthcare Provider Details

I. General information

NPI: 1831239185
Provider Name (Legal Business Name): MICHAEL JOSEPH HOFFMAN R.PH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N JORDAN AVE
BLOOMINGTON IN
47405-3190
US

IV. Provider business mailing address

3615 OSTROM CT
GREENWOOD IN
46143-7659
US

V. Phone/Fax

Practice location:
  • Phone: 812-855-8103
  • Fax:
Mailing address:
  • Phone: 317-888-8599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26017624
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: