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General NPI Number Information
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NPI Number | 1699802082
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Entity Type | Organization
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Legal Business Name | WINONA BLDG. PHARMACY, INC.
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3266 N MERIDIAN ST STE 106
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City | INDIANAPOLIS
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State | IN
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Zip | 46208-5839
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Country | US
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Telephone | 317-924-5551
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Fax | 317-924-5573
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Provider Business Mailing Address
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Address Line | PO BOX 88247 3266 N. MERIDIAN ST., #106
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City | INDIANAPOLIS
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State | IN
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Zip | 46208-0247
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Country | US
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Telephone | 317-924-5551
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Fax | 317-924-5573
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Authorized Official
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Title or Position | OWNER
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Name | MR. LAM Q NGUYEN
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Credential |
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Telephone | 317-590-0829
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | 60007748
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License Number State | IN
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