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General NPI Number Information
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NPI Number | 1023268703
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Entity Type | Organization
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Legal Business Name | BLUE RIVER PHARMACY INC
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Dates
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Enumeration Date | 09/30/2008
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Last Update Date | 06/25/2025
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Provider Practice Location Address
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Address Line | 26 S GREEN ST
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City | BROWNSBURG
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State | IN
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Zip | 46112-1251
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Country | US
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Telephone | 317-286-3506
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Fax | 317-350-2917
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Provider Business Mailing Address
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Address Line | 26 S GREEN ST
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City | BROWNSBURG
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State | IN
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Zip | 46112-1251
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Country | US
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Telephone | 317-286-3506
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Fax | 317-350-2917
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Authorized Official
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Title or Position | OWNER
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Name | JULIE ACRA
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Credential | PHARMACY
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Telephone | 317-286-3506
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 60006168A
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License Number State | IN
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