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General NPI Number Information
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NPI Number | 1700876489
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Entity Type | Organization
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Legal Business Name | PURDUE UNIVERSITY
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Dates
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Enumeration Date | 10/25/2005
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 575 STADIUM MALL DR HEINE PHARMACY BLDG ROOM 118
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City | WEST LAFAYETTE
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State | IN
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Zip | 47907-2091
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Country | US
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Telephone | 765-496-7728
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Fax | 765-496-6094
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Provider Business Mailing Address
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Address Line | 575 STADIUM MALL DR HEINE PHARMACY BLDG ROOM 118
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City | WEST LAFAYETTE
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State | IN
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Zip | 47907-2091
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Country | US
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Telephone | 765-496-7728
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Fax | 765-496-6094
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Authorized Official
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Title or Position | HIPAA PRIVACY OFFICER
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Name | HANNAH CARROLL-ALTMAN
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Credential | JD
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Telephone | 765-496-9059
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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 | 60000341A
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License Number State | IN
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