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General NPI Number Information
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NPI Number | 1770819872
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Entity Type | Organization
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Legal Business Name | FLYWHEEL HEALTHCARE LLC
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Dates
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Enumeration Date | 10/23/2009
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Last Update Date | 01/20/2022
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Provider Practice Location Address
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Address Line | 10330 N MERIDIAN ST STE 110
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City | CARMEL
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State | IN
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Zip | 46290-1024
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Country | US
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Telephone | 866-308-4990
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Fax | 877-513-6937
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Provider Business Mailing Address
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Address Line | PO BOX 3504
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City | CARMEL
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State | IN
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Zip | 46082-3504
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Country | US
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Telephone | 866-308-4990
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Fax | 877-513-6937
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | BARRY HART
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Credential | PHARMACIST
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Telephone | 317-213-5117
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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 | 265197
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | NRP.022459650-12
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PHNR.FO.60319761
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 60006208A
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License Number State | IN
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