Healthcare Provider Details

I. General information

NPI: 1164347506
Provider Name (Legal Business Name): ANDREW CHRISTOPHER LODOLO PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2003 WINTHROP AVE
INDIANAPOLIS IN
46202-2012
US

IV. Provider business mailing address

2003 WINTHROP AVE
INDIANAPOLIS IN
46202-2012
US

V. Phone/Fax

Practice location:
  • Phone: 317-880-4418
  • Fax:
Mailing address:
  • Phone: 317-880-4418
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0205X
TaxonomyCritical Care Pharmacist
License Number26024070A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: