Healthcare Provider Details

I. General information

NPI: 1578558979
Provider Name (Legal Business Name): PILL BOX PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 03/17/2017
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 TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number60006367A
License Number StateIN

VIII. Authorized Official

Name: GREGORY WINN
Title or Position: PRESIDENT
Credential: RPH
Phone: 574-267-4900