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General NPI Number Information
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NPI Number | 1427651827
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Entity Type | Individual
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Provider Name | KEVIN M RILEY
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Gender | Male
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Dates
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Enumeration Date | 11/18/2020
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Last Update Date | 11/18/2020
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Provider Practice Location Address
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Address Line | 10001 E WASHINGTON ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46229-2623
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Country | US
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Telephone | 317-897-6323
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 394
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City | SHELBYVILLE
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State | IN
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Zip | 46176-0394
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Country | US
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Telephone | 765-346-1440
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 26017192A
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License Number State | IN
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