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General NPI Number Information
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NPI Number | 1114984473
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Entity Type | Organization
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Legal Business Name | SALEM APOTHECARY, INC
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Dates
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Enumeration Date | 04/28/2006
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Last Update Date | 10/15/2020
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Provider Practice Location Address
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Address Line | 3 PUBLIC SQ
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City | SALEM
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State | IN
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Zip | 47167-2050
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Country | US
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Telephone | 812-883-4500
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Fax | 812-883-1440
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Provider Business Mailing Address
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Address Line | 3 PUBLIC SQ
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City | SALEM
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State | IN
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Zip | 47167-2050
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Country | US
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Telephone | 812-883-4500
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Fax | 812-883-1440
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Authorized Official
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Title or Position | PRESIDENT/PHARMACIST
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Name | MRS. REBECCA C MARSHALL
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Credential | R.PH.
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Telephone | 812-883-4500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 60003161
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 60003161
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License Number State | IN
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