Organization
NEPHEW PHARMACY PC
Active
Other names
Nephew Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
GARY NEPHEW (PRESIDENT, AO)
(574) 537-1111
Entity
Organization
Contact information
Practice address
2824 ELKHART RD, GOSHEN, IN 46526-1014
(574) 537-1111
(574) 537-1130
Mailing address
2824 ELKHART RD, GOSHEN, IN 46526-1014
(574) 537-1111
(574) 537-1130
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
60006583A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2165965
PK
—
Enumeration date
10/12/2016
Last updated
02/08/2021
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