Organization
PANACEA PHARMACY INC
Active
Other names
Panacea Pharmacy Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA ANDERSON (PRESIDENT)
(812) 276-5782
Entity
Organization
Contact information
Practice address
2424 S WALNUT ST, BLOOMINGTON, IN 47401-7730
(812) 287-8884
(812) 287-8921
Mailing address
PO BOX 366, BEDFORD, IN 47421-0366
(812) 276-5782
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
60006429A
IN
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201282000A
—
IN
01
—
2150437
PK
—
Enumeration date
02/16/2015
Last updated
04/20/2017
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