Organization
BLUE RIVER PHARMACY INC
Active
Other names
Blue River Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL CRUZAN (PRESIDENT)
(317) 286-3506
Entity
Organization
Contact information
Practice address
26 S GREEN ST, BROWNSBURG, IN 46112-1251
(317) 286-3506
(317) 350-2917
Mailing address
26 S GREEN ST, BROWNSBURG, IN 46112-1251
(317) 286-3506
(317) 350-2917
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200914920A
—
IN
Enumeration date
06/17/2021
Last updated
06/25/2025
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