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NPI Code Detail

MEDICARE: NITA MARIE LA FOLLETTE R.PH.

MEDICARE: NITA MARIE LA FOLLETTE R.PH.
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
1183500000XPharmacist26016430AIN

General Provider Information

NPI Number : 1942340435
Entity Type Code : Individual
Provider Name (Legal Business Name) : NITA MARIE LA FOLLETTE R.PH.
Provider Business Mailing Address
First Line : 5385 N 400 W
Second Line :
City : LA PORTE
State : IN
Zip : 46350-7536
Country : US
Telephone Number : 219-324-9904
Fax Number :
Provider Business Practice Location Address
First Line : 2022 KELLE DR
Second Line :
City : CHESTERTON
State : IN
Zip : 46304-8708
Country : US
Telephone Number : 219-395-8100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2007
Last Update Date : 07/08/2007

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Directions to “ NITA MARIE LA FOLLETTE R.PH.” Practice Location

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