Organization
THE SOUTH BEND CLINIC PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANDREA KRUPA (EXEC DIRECTOR PHARMACY)
(574) 239-1461
Entity
Organization
Contact information
Practice address
211 N EDDY ST, SOUTH BEND, IN 46617
(574) 237-9295
(574) 239-1554
Mailing address
211 N EDDY ST, SOUTH BEND, IN 46617-2808
(574) 237-9295
(574) 239-1554
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
60004874A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100300930
—
IN
01
—
1507221
NABP OR NCPDP
IN
Enumeration date
02/27/2007
Last updated
11/22/2024
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