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Organization

MARWOOD LOW COST PHARMACY

Active
Parent organization
MARWOOD LOW COST PHARMACY
Other names
MARWOOD LOW COST PHARMACY
Organization subpart
Yes

Provider details

NPI number
Legal business name
MARWOOD LOW COST PHARMACY
Authorized official
METHQAL ABU-MAHFOUZ (PHARMACIST)
(317) 590-1271
Entity
Organization

Contact information

Practice address
3381 KENTUCKY AVE, INDIANAPOLIS, IN 46221-2305
(317) 246-6700
Mailing address
3381 KENTUCKY AVE, INDIANAPOLIS, IN 46221-2305
(317) 246-6700

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
333600000X
Pharmacy
Primary
60006189A
IN
3336C0003X
Community/Retail Pharmacy
3336S0011X
Specialty Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1562582
NCPDP PROVIDER IDENTIFICATION NUMBER
05
200932340A
IN
Enumeration date
11/24/2008
Last updated
04/03/2012
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