Healthcare Provider Details

I. General information

NPI: 1922381433
Provider Name (Legal Business Name): VAUNE R TAYLOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2011
Last Update Date: 09/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1516 E MAIN ST
PLAINFIELD IN
46168-1791
US

IV. Provider business mailing address

606 N COUNTY ROAD 900 E
AVON IN
46123-5448
US

V. Phone/Fax

Practice location:
  • Phone: 317-838-9187
  • Fax: 317-838-7421
Mailing address:
  • Phone: 317-292-4853
  • Fax: 317-271-9802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26015206
License Number StateIN

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: