Healthcare Provider Details

I. General information

NPI: 1265038855
Provider Name (Legal Business Name): JAMES C KOCHER PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2020
Last Update Date: 12/08/2020
Certification Date: 12/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7930 MADISON AVE
INDIANAPOLIS IN
46227-5609
US

IV. Provider business mailing address

7930 MADISON AVE
INDIANAPOLIS IN
46227-5609
US

V. Phone/Fax

Practice location:
  • Phone: 317-885-2360
  • Fax:
Mailing address:
  • Phone: 317-885-2360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26025629A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: