Healthcare Provider Details

I. General information

NPI: 1245722230
Provider Name (Legal Business Name): DEBRA WINTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2018
Last Update Date: 06/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1481 W 10TH ST
INDIANAPOLIS IN
46202-2803
US

IV. Provider business mailing address

8110 E COUNTY ROAD 700 N
BROWNSBURG IN
46112-9069
US

V. Phone/Fax

Practice location:
  • Phone: 317-988-2583
  • Fax:
Mailing address:
  • Phone: 317-544-9514
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26021427A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: