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Organization
MARWOOD LOW COST PHARMACY
Active
Organization
MARWOOD LOW COST PHARMACY
Active
Parent organization
MARWOOD LOW COST PHARMACY
Other names
MARWOOD LOW COST PHARMACY
Organization subpart
Yes
Provider details
NPI number
Legal business name
MARWOOD LOW COST PHARMACY
Authorized official
METHQAL ABU-MAHFOUZ (PHARMACIST)
(317) 590-1271
Entity
Organization
Contact information
Practice address
3381 KENTUCKY AVE, INDIANAPOLIS, IN 46221-2305
(317) 246-6700
Mailing address
3381 KENTUCKY AVE, INDIANAPOLIS, IN 46221-2305
(317) 246-6700
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
60006189A
IN
3336C0003X
Community/Retail Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1562582
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
200932340A
—
IN
Enumeration date
11/24/2008
Last updated
04/03/2012
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