Organization
DEKALB MEMORIAL PHARMACARE LLC
Active
Organization
DEKALB MEMORIAL PHARMACARE LLC
Active
Other names
DeKalb Health PharmaCare Garrett
Organization subpart
No
Provider details
NPI number
Authorized official
STANTON RISSER (ACFO)
(260) 266-9380
Entity
Organization
Contact information
Practice address
1350 S RANDOLPH ST, GARRETT, IN 46738-1971
(260) 553-9200
(260) 553-9201
Mailing address
1350 S RANDOLPH ST, GARRETT, IN 46738-1971
(260) 553-9200
(260) 553-9201
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
60006582A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2164066
PK
—
Enumeration date
10/14/2016
Last updated
10/31/2024
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