Organization
ACCUPAX LLC
Active
Other names
AccuPax LLC
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD KUTRIEB (PRESIDENT & CEO)
(312) 287-7345
Entity
Organization
Contact information
Practice address
8770 GUION RD, STE A, INDIANAPOLIS, IN 46268-3042
(800) 978-0531
(888) 688-9466
Mailing address
8770 GUION RD, STE A, INDIANAPOLIS, IN 46268-3042
(317) 829-5454
(317) 829-0541
Taxonomy
Speciality
Code
Description
License number
State
3336S0011X
Specialty Pharmacy
Primary
054.016756
IL
3336S0011X
Specialty Pharmacy
60006158A
IN
3336S0011X
Specialty Pharmacy
MO0560118
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1562417
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
200936340A
—
IN
Enumeration date
08/05/2008
Last updated
09/18/2009
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