Healthcare Provider Details

I. General information

NPI: 1497588412
Provider Name (Legal Business Name): ANDREW FORTE PHARMD, RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2024
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

929 S 13TH ST
DECATUR IN
46733-1805
US

IV. Provider business mailing address

4339 ALUMROOT DR
FORT WAYNE IN
46845-8003
US

V. Phone/Fax

Practice location:
  • Phone: 260-724-9187
  • Fax:
Mailing address:
  • Phone: 260-450-6603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number26030973A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: