Healthcare Provider Details

I. General information

NPI: 1558437061
Provider Name (Legal Business Name): PILL BOX PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 10/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2306 DUBOIS DR
WARSAW IN
46580-3213
US

IV. Provider business mailing address

2306 DUBOIS DR
WARSAW IN
46580-3213
US

V. Phone/Fax

Practice location:
  • Phone: 574-267-4900
  • Fax: 574-267-8028
Mailing address:
  • Phone: 574-267-4900
  • Fax: 574-267-8028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number332BX200X
License Number StateIN

VIII. Authorized Official

Name: MRS. RITA K ADAMS
Title or Position: DIRECTOR OF DME SERVICES
Credential:
Phone: 574-267-4900