Healthcare Provider Details

I. General information

NPI: 1538400874
Provider Name (Legal Business Name): STACEY PRICE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2013
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 W 161ST ST
WESTFIELD IN
46074-8565
US

IV. Provider business mailing address

17729 SANIBEL CIR
WESTFIELD IN
46062-7636
US

V. Phone/Fax

Practice location:
  • Phone: 317-867-4187
  • Fax: 317-896-9763
Mailing address:
  • Phone: 317-590-3909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26021450A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number26021450A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: