Organization
MARY RUTAN INDIAN LAKE PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA MYERS (COO)
(937) 599-7034
Entity
Organization
Contact information
Practice address
120 W MAIN ST, RUSSELLS POINT, OH 43348-7500
(937) 292-5024
(937) 292-3576
Mailing address
205 E PALMER RD, BELLEFONTAINE, OH 43311-2281
(937) 292-5024
(937) 292-3576
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
09/05/2025
Last updated
12/19/2025
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