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NPI Code Detail

MEDICARE: JOHN EDWARD MASSA RPH

MEDICARE: JOHN EDWARD MASSA RPH
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
11835P1200XPharmacotherapy Pharmacist26011997AIN

General Provider Information

NPI Number : 1023158581
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN EDWARD MASSA RPH
Provider Business Mailing Address
First Line : 32 TOWER RD
Second Line :
City : VALPARAISO
State : IN
Zip : 46385-9282
Country : US
Telephone Number : 219-464-4546
Fax Number :
Provider Business Practice Location Address
First Line : 2022 KELLE DR
Second Line :
City : CHESTERTON
State : IN
Zip : 46304-8708
Country : US
Telephone Number : 219-395-8100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2007
Last Update Date : 12/21/2025

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