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General NPI Number Information
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NPI Number | 1871084798
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Entity Type | Organization
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Legal Business Name | SD&J LLC T A MADE-IN INDIANAPOLIS PHARMACY & MEDICAL EQUIPMENT
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Dates
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Enumeration Date | 05/25/2018
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Last Update Date | 10/09/2018
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Provider Practice Location Address
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Address Line | 3350 N HIGH SCHOOL RD STE J
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City | INDIANAPOLIS
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State | IN
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Zip | 46224-2050
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Country | US
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Telephone | 317-438-5236
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Fax | 833-274-8633
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Provider Business Mailing Address
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Address Line | 3350 N HIGH SCHOOL RD STE J
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City | INDIANAPOLIS
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State | IN
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Zip | 46224-2050
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Country | US
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Telephone | 317-438-5236
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Fax | 833-274-8632
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Authorized Official
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Title or Position | PARTNER
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Name | JACK R WELLS JR.
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Credential | RPH
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Telephone | 317-696-6668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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