Organization
NEPHEW PHARMACY PC
Active
Other names
Nephew Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
GARY NEPHEW RPH (PRESIDENT/OWNER/PIC/AO)
(574) 286-2259
Entity
Organization
Contact information
Practice address
1953 WATERFALL DR, NAPPANEE, IN 46550-8961
(574) 773-2404
(574) 773-2401
Mailing address
1953 WATERFALL DR, NAPPANEE, IN 46550-8961
(574) 773-2404
(574) 773-2401
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
60006498A
IN
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2151965
PK
—
Enumeration date
05/14/2015
Last updated
02/08/2021
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