Organization
STATE OF INDIANA AUDITOR OF STATE
Active
Other names
EVANSVILLE STATE HOSPITAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
AMY ARY PHARMD (PHARMACY DIRECTOR)
(812) 469-6800
Entity
Organization
Contact information
Practice address
3400 LINCOLN AVE, EVANSVILLE, IN 47714-0147
(812) 469-6800
(812) 469-6825
Mailing address
3400 LINCOLN AVE, EVANSVILLE, IN 47714-0147
(812) 469-6800
(812) 469-6825
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336I0012X
Institutional Pharmacy
Primary
60000751A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2025178
PK
—
Enumeration date
06/09/2006
Last updated
09/14/2016
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