MEDICARE: WEBB'S FAMILY PHARMACY INC

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	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336L0003X	Long Term Care Pharmacy	60004015	IN
3	3336C0003X	Community/Retail Pharmacy	60004015	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1528352	OTHER		NCPDP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	4GSIH3E00	OTHER		HIN
4	60004015	OTHER	IN	INDIANA PHARMACY PERMIT

General Provider Information

NPI Number	:	1831289974
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEBB'S FAMILY PHARMACY INC

Provider Business Mailing Address
First Line	:	724 MAIN ST
Second Line	:
City	:	ROCHESTER
State	:	IN
Zip	:	46975-1506
Country	:	US
Telephone Number	:	574-223-2216
Fax Number	:	574-223-3987

Provider Business Practice Location Address
First Line	:	724 MAIN ST
Second Line	:
City	:	ROCHESTER
State	:	IN
Zip	:	46975-1506
Country	:	US
Telephone Number	:	574-223-2216
Fax Number	:	574-223-3987

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HARRY ROBERT WEBB
Credential	:	PD
Telephone Number	:	574-223-2216

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	03/04/2009

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