Healthcare Provider Details

I. General information

NPI: 1891389490
Provider Name (Legal Business Name): NRS PHARMACIES OF INDIANA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2021
Last Update Date: 12/05/2022
Certification Date: 12/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W MAIN ST STE A
CAMBRIDGE CITY IN
47327-1118
US

IV. Provider business mailing address

132 W MONROE AVE
KIRKWOOD MO
63122-5816
US

V. Phone/Fax

Practice location:
  • Phone: 765-334-8331
  • Fax: 765-334-8346
Mailing address:
  • Phone: 314-960-7300
  • Fax: 314-965-4706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN SOMMER
Title or Position: VP FINANCE AND ADMIN
Credential:
Phone: 314-965-4700