Individual
PADEN LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
100 EAST U.S. 231, CROWN POINT, IN 46307
(219) 662-8893
Mailing address
904 JORDAN CIR, SCHERERVILLE, IN 46375-2280
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
051303299
IL
183500000X
Pharmacist
Primary
26028721A
IN
Other
Enumeration date
11/23/2020
Last updated
11/23/2020
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