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General NPI Number Information
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NPI Number | 1518015874
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Entity Type | Organization
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Legal Business Name | NORTH MANCHESTER PHARMACIES
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1202 STATE ROAD 114 W
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City | NORTH MANCHESTER
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State | IN
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Zip | 46962-1946
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Country | US
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Telephone | 260-982-4224
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Fax | 260-982-2853
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Provider Business Mailing Address
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Address Line | 1202 STATE ROAD 114 W
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City | NORTH MANCHESTER
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State | IN
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Zip | 46962-1946
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Country | US
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Telephone | 260-982-4224
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Fax | 260-982-2853
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Authorized Official
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Title or Position | OWNER
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Name | MR. SCOTT LYNN EBERLY
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Credential |
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Telephone | 260-982-4224
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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 | 26014537A
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License Number State | IN
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