Organization
STATE OF INDIANA AUDITOR OF STATE
Active
Other names
NeuroDiagnostic Institute Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA L RUTHERFORD (CONTROLLER, INDIANA FAMILY & SOCIAL)
(317) 232-7862
Entity
Organization
Contact information
Practice address
5435 EAST 16TH STREET, INDIANAPOLIS, IN 46218-5101
(317) 941-4000
(317) 941-4378
Mailing address
5435 EAST 16TH STREET, INDIANAPOLIS, IN 46218-5101
(317) 941-4000
(317) 941-4378
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336I0012X
Institutional Pharmacy
Primary
60001313A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100273130A
—
IN
01
—
2024895
PK
—
Enumeration date
07/30/2006
Last updated
01/09/2019
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