Healthcare Provider Details

I. General information

NPI: 1770120883
Provider Name (Legal Business Name): BENJAMIN NEUENSCHWANDER PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2019
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9851 E 59TH ST
INDIANAPOLIS IN
46216-1124
US

IV. Provider business mailing address

10017 SCHUYLER CT
FORT WAYNE IN
46804-4377
US

V. Phone/Fax

Practice location:
  • Phone: 317-377-2305
  • Fax:
Mailing address:
  • Phone: 765-669-3162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0207X
TaxonomyCompounded Sterile Preparations Pharmacist
License Number26023779A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: