MEDICARE: MARSH DRUGS LLC

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
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	60005094A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2026965	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396750204
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARSH DRUGS LLC

Provider Business Mailing Address
First Line	:	9800 CROSSPOINT BLVD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46256-3300
Country	:	US
Telephone Number	:	317-594-2100
Fax Number	:	317-598-3961

Provider Business Practice Location Address
First Line	:	7400 FISHERS STATION DR
Second Line	:
City	:	FISHERS
State	:	IN
Zip	:	46038-2323
Country	:	US
Telephone Number	:	317-577-5329
Fax Number	:	317-585-1583

Authorized Official
Title or Position	:	MANAGER
Name	:	CORINNE MILBURN
Credential	:	RPH
Telephone Number	:	317-577-5329

Provider Enumeration Date	:	07/29/2006
Last Update Date	:	03/26/2015

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