Healthcare Provider Details

I. General information

NPI: 1871412015
Provider Name (Legal Business Name): AVERY LAUREN VONDIELINGEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7910 E WASHINGTON ST STE 200
INDIANAPOLIS IN
46219-5563
US

IV. Provider business mailing address

7910 E WASHINGTON ST STE 200
INDIANAPOLIS IN
46219-5563
US

V. Phone/Fax

Practice location:
  • Phone: 317-355-9309
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number26031312A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: