Healthcare Provider Details

I. General information

NPI: 1710895362
Provider Name (Legal Business Name): ANDREW THOMPSON LOPEZ PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 PRINCE WILLIAM RD
DELPHI IN
46923-1758
US

IV. Provider business mailing address

6442 SHALE CRESCENT DR
WEST LAFAYETTE IN
47906-8938
US

V. Phone/Fax

Practice location:
  • Phone: 765-564-3016
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26031525A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: