Healthcare Provider Details
I. General information
NPI: 1548151400
Provider Name (Legal Business Name): INDIANA HEALTH CENTERS, INC. PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/10/2025
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3710 S WESTERN AVE
MARION IN
46953-4827
US
IV. Provider business mailing address
8003 CASTLEWAY DR
INDIANAPOLIS IN
46250-1946
US
V. Phone/Fax
- Phone: 765-263-8577
- Fax:
- Phone: 317-576-1335
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANN
LUNDY
Title or Position: CEO
Credential: MBA
Phone: 317-576-1335