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General NPI Number Information
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NPI Number | 1538143169
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Entity Type | Organization
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Legal Business Name | LADD REXALL DRUGS
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Dates
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Enumeration Date | 12/06/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 102 W. MC CONNELL ST.
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City | OXFORD
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State | IN
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Zip | 47971-0063
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Country | US
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Telephone | 765-385-2166
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Fax |
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Provider Business Mailing Address
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Address Line | 102 W. MC CONNELL ST.
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City | OXFORD
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State | IN
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Zip | 47971-0063
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Country | US
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Telephone | 765-385-2166
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DEBORAH L LADD
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Credential | BS
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Telephone | 765-385-2166
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 6000118A
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License Number State | IN
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