=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891389490
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NRS PHARMACIES OF INDIANA LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/24/2021
-----------------------------------------------------
Last Update Date | 01/08/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 100 W MAIN ST STE A
-----------------------------------------------------
City | CAMBRIDGE CITY
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47327-1118
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 765-334-8331
-----------------------------------------------------
Fax | 765-334-8346
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 755 S NEW BALLAS RD
-----------------------------------------------------
City | SAINT LOUIS
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63141-8703
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-960-7300
-----------------------------------------------------
Fax | 314-965-4706
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VP FINANCE AND ADMIN
-----------------------------------------------------
Name | STEPHEN SOMMER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 314-965-4700
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336L0003X
-----------------------------------------------------
Taxonomy Name | Long Term Care Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------