Individual
THOMAS DELLAVILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
4750 E 450 S, WHITESTOWN, IN 46075-8404
(877) 732-3431
Mailing address
6336 OAKLANDON RD, INDIANAPOLIS, IN 46236-2959
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26028750A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26028750A
PHARMACY LICENSE
—
Enumeration date
11/30/2020
Last updated
06/28/2023
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