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General NPI Number Information
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NPI Number | 1750984530
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Entity Type | Individual
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Provider Name | ANITA LYNN LAWRENCE PHARMD
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Gender | Female
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Dates
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Enumeration Date | 11/16/2020
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Last Update Date | 11/16/2020
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Provider Practice Location Address
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Address Line | 715 E BROADWAY ST
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City | FORTVILLE
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State | IN
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Zip | 46040-1551
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Country | US
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Telephone | 317-485-7111
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Fax |
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Provider Business Mailing Address
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Address Line | 4841 E 71ST ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46220-3889
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Country | US
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Telephone | 317-442-6784
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 26020938A
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License Number State | IN
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