Healthcare Provider Details

I. General information

NPI: 1427478247
Provider Name (Legal Business Name): SUSAN KIRKHAM PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2014
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 W MICHIGAN ST
INDIANAPOLIS IN
46204-1242
US

IV. Provider business mailing address

227 W MICHIGAN ST
INDIANAPOLIS IN
46204-1242
US

V. Phone/Fax

Practice location:
  • Phone: 317-262-5267
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26022516A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: