Organization
MOROCCO DRUGS INC
Active
Other names
FAGEN PHARMACY 9
Organization subpart
No
Provider details
NPI number
Authorized official
CONNIE COFFER (3RD PARTY COORD)
(219) 987-6468
Entity
Organization
Contact information
Practice address
505 S POLK, MOROCCO, IN 47963-0010
(219) 285-2670
(219) 285-8288
Mailing address
PO BOX 9830, FAGEN PHARMACY, SALT LAKE CITY, UT 84109-9913
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
60003224
IN
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100300060
—
IN
01
—
1523910
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/21/2006
Last updated
05/22/2008
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