MEDICARE: MHP PHARMACY 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	60005853	IN

General Provider Information

NPI Number	:	1558355537
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MHP PHARMACY LLC

Provider Business Mailing Address
First Line	:	101 W 103RD ST
Second Line	:	INH 515
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46290-1102
Country	:	US
Telephone Number	:	888-852-1553
Fax Number	:	888-852-1759

Provider Business Practice Location Address
First Line	:	101 W 103RD ST
Second Line	:	INH 515
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46290-1102
Country	:	US
Telephone Number	:	888-852-1553
Fax Number	:	888-852-1759

Authorized Official
Title or Position	:	CEO
Name	:	BARRY JOHN HART
Credential	:	R PH
Telephone Number	:	317-213-5117

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	08/22/2020

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