Organization
IBP PHARMACY INC
Active
Other names
IBP Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
NATASHA BANKS (PRESIDENT)
(708) 552-7683
Entity
Organization
Contact information
Practice address
2075 INDIANAPOLIS BLVD, WHITING, IN 46394-1948
(219) 659-5047
(219) 659-5039
Mailing address
2075 INDIANAPOLIS BLVD, WHITING, IN 46394-1948
(219) 659-5029
(219) 659-5039
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
60006224A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1563065
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/30/2010
Last updated
09/10/2010
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