MEDICARE: DAMAR PHARMACY SERVICES

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	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1700413721
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAMAR PHARMACY SERVICES

Provider Business Mailing Address
First Line	:	6067 DECATUR BLVD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46241-9606
Country	:	US
Telephone Number	:	317-856-5201
Fax Number	:	317-856-2333

Provider Business Practice Location Address
First Line	:	5715 DECATUR BLVD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46241-9561
Country	:	US
Telephone Number	:	317-856-5201
Fax Number	:	317-856-2333

Authorized Official
Title or Position	:	PRESIDENT AND CEO
Name	:	DR. JIM L DALTON
Credential	:	PSYD
Telephone Number	:	317-455-7106

Provider Enumeration Date	:	03/27/2020
Last Update Date	:	08/04/2025

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