Organization
ODON PHARMACY LLC
Active
Other names
ODON PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH HOLLAND RPH (OWNER,PIC,AO)
(812) 636-4600
Entity
Organization
Contact information
Practice address
200 W MAIN ST, ODON, IN 47562-1218
(812) 636-4600
(812) 636-8004
Mailing address
PO BOX 355, ODON, IN 47562-0355
(812) 636-4600
(812) 636-8004
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
60003675A
IN
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100294700A
—
IN
01
—
2026659
PK
—
Enumeration date
06/16/2006
Last updated
10/27/2015
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