Healthcare Provider Details

I. General information

NPI: 1871874271
Provider Name (Legal Business Name): REBECCA TODD GARMON RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2011
Last Update Date: 08/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12570 REYNOLDS DR
FISHERS IN
46038-9266
US

IV. Provider business mailing address

5402 ALVAMAR PL
CARMEL IN
46033-8840
US

V. Phone/Fax

Practice location:
  • Phone: 317-849-9116
  • Fax: 317-849-9179
Mailing address:
  • Phone: 317-373-1035
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26022255A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: