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Organization
PURDUE UNIVERSITY
Active
Organization
PURDUE UNIVERSITY
Active
Other names
Patterson-McCallum-Mareta Charitable Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JASMINE GONZALVO PHARMD, MPH (HIPAA LIAISON)
(317) 880-5406
Entity
Organization
Contact information
Practice address
3737 WALDEMERE AVE STE 300, INDIANAPOLIS, IN 46241-7234
(317) 880-5406
Mailing address
640 ESKENAZI AVE, FIFTH THIRD BANK FOB, PURDUE UNIVERSITY DEPT PHARMACY PRACTICE, 3RD FLOOR, INDIANAPOLIS, IN 46202
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Enumeration date
09/22/2025
Last updated
09/22/2025
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