Healthcare Provider Details

I. General information

NPI: 1770819872
Provider Name (Legal Business Name): FLYWHEEL HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2009
Last Update Date: 01/20/2022
Certification Date: 04/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10330 N MERIDIAN ST STE 110
CARMEL IN
46290-1024
US

IV. Provider business mailing address

PO BOX 3504
CARMEL IN
46082-3504
US

V. Phone/Fax

Practice location:
  • Phone: 866-308-4990
  • Fax: 877-513-6937
Mailing address:
  • Phone: 866-308-4990
  • Fax: 877-513-6937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number265197
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License NumberNRP.022459650-12
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPHNR.FO.60319761
License Number StateWA
# 4
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number60006208A
License Number StateIN

VIII. Authorized Official

Name: BARRY HART
Title or Position: MANAGING PARTNER
Credential: PHARMACIST
Phone: 317-213-5117