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NPI Code Detail

MEDICARE: DR. DEREK C JOHNSON PHARM D

MEDICARE: DR. DEREK C JOHNSON PHARM D
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
1183500000XPharmacist26023671AIN

General Provider Information

NPI Number : 1811544315
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEREK C JOHNSON PHARM D
Provider Business Mailing Address
First Line : 4952 ABIGAIL DR
Second Line :
City : WESTFIELD
State : IN
Zip : 46062-9348
Country : US
Telephone Number : 812-878-5132
Fax Number :
Provider Business Practice Location Address
First Line : 8330 CRAWFORDSVILLE RD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46234-1714
Country : US
Telephone Number : 317-347-4411
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2019
Last Update Date : 08/20/2019

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