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NPI Code Detail

MEDICARE: ELVIEANNA LYNNE HAINES PHARM D

MEDICARE: ELVIEANNA LYNNE HAINES PHARM D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist26026396AIN
2183500000XPharmacist15108OK

General Provider Information

NPI Number : 1003243114
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELVIEANNA LYNNE HAINES PHARM D
Provider Business Mailing Address
First Line : 455 E EPLER AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46227-1902
Country : US
Telephone Number : 317-788-6671
Fax Number :
Provider Business Practice Location Address
First Line : 455 E EPLER AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46227-1902
Country : US
Telephone Number : 317-788-6671
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2013
Last Update Date : 02/14/2024

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