Healthcare Provider Details

I. General information

NPI: 1346934825
Provider Name (Legal Business Name): JPCHC PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2023
Last Update Date: 07/06/2023
Certification Date: 07/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5317 E 16TH ST
INDIANAPOLIS IN
46218-4897
US

IV. Provider business mailing address

5317 E 16TH ST
INDIANAPOLIS IN
46218-4897
US

V. Phone/Fax

Practice location:
  • Phone: 317-934-0778
  • Fax:
Mailing address:
  • Phone: 317-934-0778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: AARON KNAPP
Title or Position: DIRECTOR OF PHARMACY OPERATIONS
Credential: PHARMD
Phone: 812-632-0917