Organization
JR PHARMACY POPLAR LLC
Active
Other names
JR PHARMACY POPLAR LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRY J WARREN (PRESIDENT)
(765) 828-1003
Entity
Organization
Contact information
Practice address
1101 POPLAR ST, TERRE HAUTE, IN 47807-4565
(812) 235-7373
(812) 478-0459
Mailing address
1238 S 3RD ST STE C, TERRE HAUTE, IN 47802-0018
(812) 234-8305
(812) 234-0225
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
60005675A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200375570A
—
IN
01
—
2024532
PK
—
Enumeration date
09/12/2006
Last updated
01/22/2026
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