# EXTENDED PHARMACY 2 LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780151191
- **Authorized official:** ADAM MCCOY PHARM. D. (OWNER)
- **Authorized official phone:** (317) 343-2056

## Contact information

- **Practice address:** 6030 W 62ND ST, INDIANAPOLIS, IN 46278-2909
- **Practice address phone:** (317) 343-2056
- **Practice address fax:** (877) 361-5651
- **Mailing address:** 6030 W 62ND ST, INDIANAPOLIS, IN 46278-2909
- **Mailing address phone:** (317) 343-2056
- **Mailing address fax:** (877) 361-5651

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 10/24/2018
- **Last updated:** 09/28/2023