Healthcare Provider Details

I. General information

NPI: 1255204327
Provider Name (Legal Business Name): LUCAS HOFFMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2025
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

744 E TOURNAMENT TRL
WESTFIELD IN
46074-6217
US

IV. Provider business mailing address

720 S RANGELINE RD APT 420
CARMEL IN
46032-3072
US

V. Phone/Fax

Practice location:
  • Phone: 317-399-3074
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26030840A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: