# STATE OF INDIANA AUDITOR OF STATE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** NeuroDiagnostic Institute Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356356968
- **Authorized official:** DONNA L RUTHERFORD (CONTROLLER, INDIANA FAMILY & SOCIAL)
- **Authorized official phone:** (317) 232-7862

## Contact information

- **Practice address:** 5435 EAST 16TH STREET, INDIANAPOLIS, IN 46218-5101
- **Practice address phone:** (317) 941-4000
- **Practice address fax:** (317) 941-4378
- **Mailing address:** 5435 EAST 16TH STREET, INDIANAPOLIS, IN 46218-5101
- **Mailing address phone:** (317) 941-4000
- **Mailing address fax:** (317) 941-4378

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336I0012X | Institutional Pharmacy | 60001313A | IN | Yes |

## Other

- **Enumeration date:** 07/30/2006
- **Last updated:** 01/09/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100273130A | — | IN |
| 01 | — | 2024895 | PK | — |