Healthcare Provider Details

I. General information

NPI: 1548806854
Provider Name (Legal Business Name): ANDREA PANYARD PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANDREA HOFFMAN

II. Dates (important events)

Enumeration Date: 11/21/2019
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821 LINCOLN HWY W
NEW HAVEN IN
46774-2139
US

IV. Provider business mailing address

15479 CANYON BAY RUN
FORT WAYNE IN
46845-8658
US

V. Phone/Fax

Practice location:
  • Phone: 260-749-0215
  • Fax:
Mailing address:
  • Phone: 260-433-7644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26028346A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number26028346A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: