Organization
GOSHEN HOSPITAL ASSOCIATION INC
Active
Other names
Goshen Cancer Center Outpatient Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK SCHNEIDER (DIRECTOR OF PHARMACY)
(574) 364-2651
Entity
Organization
Contact information
Practice address
200 HIGH PARK AVE, GOSHEN, IN 46526-4810
(574) 364-2803
(574) 364-2804
Mailing address
PO BOX 139, GOSHEN, IN 46527-0139
(574) 364-2803
(574) 364-2804
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
60001389A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200984460A
—
IN
01
—
2122794
PK
—
Enumeration date
01/08/2010
Last updated
09/17/2021
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