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General NPI Number Information
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NPI Number | 1578680666
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Entity Type | Organization
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Legal Business Name | STATE OF INDIANA, AUDITOR OF STATE
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 498 NW 18TH ST
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City | RICHMOND
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State | IN
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Zip | 47374-2851
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Country | US
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Telephone | 765-966-0511
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Fax |
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Provider Business Mailing Address
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Address Line | 498 NW 18TH ST
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City | RICHMOND
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State | IN
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Zip | 47374-2851
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Country | US
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Telephone | 765-966-0511
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Fax |
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Authorized Official
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Title or Position | SUPERINTENDENT
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Name | MR. JEFFREY BUTLER
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Credential |
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Telephone | 765-966-0511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number | 60000031A
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License Number State | IN
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