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General NPI Number Information
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NPI Number | 1902695802
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Entity Type | Organization
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Legal Business Name | ASPIRE INDIANA PHARMACY, LLC
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Dates
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Enumeration Date | 05/06/2025
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 17840 CUMBERLAND RD RM 300
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City | NOBLESVILLE
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State | IN
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Zip | 46060-5409
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Country | US
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Telephone | 317-268-5319
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Fax | 800-650-2055
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Provider Business Mailing Address
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Address Line | 9615 E 148TH ST STE 1
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City | NOBLESVILLE
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State | IN
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Zip | 46060-4371
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Country | US
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Telephone | 317-268-5319
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Fax | 317-449-5959
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Authorized Official
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Title or Position | CFO
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Name | TIMOTHY CROCKETT
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Credential |
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Telephone | 317-587-0505
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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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