Organization
UPLAND FAMILY PHARMACY LLC
Active
Other names
Upland Family Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN RALSTON (OWNER/MANAGER)
(260) 375-6136
Entity
Organization
Contact information
Practice address
1809 S MAIN ST STE 150, UPLAND, IN 46989-9259
(765) 998-8072
(765) 998-8094
Mailing address
1809 S MAIN ST STE 150, UPLAND, IN 46989-9259
(765) 998-8072
(765) 998-8094
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
60006517A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201335170A
—
IN
01
—
2155564
PK
—
Enumeration date
12/02/2015
Last updated
09/19/2025
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