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General NPI Number Information
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NPI Number | 1487370961
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Entity Type | Individual
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Provider Name | DEANNA IVA MANIAR
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Gender | Female
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Dates
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Enumeration Date | 10/17/2022
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Last Update Date | 10/17/2022
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Provider Practice Location Address
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Address Line | 265 S SCATTERFIELD RD
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City | ANDERSON
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State | IN
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Zip | 46012-5106
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Country | US
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Telephone | 765-643-3400
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Fax |
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Provider Business Mailing Address
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Address Line | 6204 BLISS PT E
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City | WHITESTOWN
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State | IN
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Zip | 46075-4422
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Country | US
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Telephone | 732-580-6783
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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 | 26023851A
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License Number State | IN
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