MEDICARE: FLYWHEEL HEALTHCARE 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	3336C0004X	Compounding Pharmacy	265197	MN
2	3336S0011X	Specialty Pharmacy	NRP.022459650-12	OH
3	333600000X	Pharmacy	PHNR.FO.60319761	WA
4	3336L0003X	Long Term Care Pharmacy	60006208A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2122500	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770819872
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLYWHEEL HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	PO BOX 3504
Second Line	:
City	:	CARMEL
State	:	IN
Zip	:	46082-3504
Country	:	US
Telephone Number	:	866-308-4990
Fax Number	:	877-513-6937

Provider Business Practice Location Address
First Line	:	10330 N MERIDIAN ST STE 110
Second Line	:
City	:	CARMEL
State	:	IN
Zip	:	46290-1024
Country	:	US
Telephone Number	:	866-308-4990
Fax Number	:	877-513-6937

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	BARRY HART
Credential	:	PHARMACIST
Telephone Number	:	317-213-5117

Provider Enumeration Date	:	10/23/2009
Last Update Date	:	01/20/2022

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Directions to “FLYWHEEL HEALTHCARE LLC ” Practice Location

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