Healthcare Provider Details

I. General information

NPI: 1497034532
Provider Name (Legal Business Name): PHARMANEEK INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2011
Last Update Date: 09/29/2020
Certification Date: 09/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7345 WOODLAND DR. SUITE A
INDIANAPOLIS IN
46278-1785
US

IV. Provider business mailing address

7345 WOODLAND DR. SUITE A
INDIANAPOLIS IN
46278
US

V. Phone/Fax

Practice location:
  • Phone: 317-293-1700
  • Fax: 317-536-3100
Mailing address:
  • Phone: 317-293-1700
  • Fax: 317-536-3100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number60006268A
License Number StateIN

VIII. Authorized Official

Name: MATTHEW GLENN HAMM
Title or Position: VICE PRESIDENT
Credential:
Phone: 317-293-1700