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Organization

PROFESSIONAL ARTS PHARMACY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JEFFERY J FERGUSON (COMPLIANCE OFFICER)
(765) 662-4051
Entity
Organization

Contact information

Practice address
330 N WABASH AVE, MARION, IN 46952-2600
(765) 664-2247
(765) 664-2328
Mailing address
441 N WABASH AVE, MARION, IN 46952-2612
(765) 662-1441
(765) 651-7351

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26015280A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100296300
IN
Enumeration date
09/30/2005
Last updated
09/15/2008
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