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STATE OF INDIANA, AUDITOR OF STATE

Suppliers Pharmacy Institutional Pharmacy

Provider NPI: 1376660027

Organization Information:
Organization Name:  STATE OF INDIANA, AUDITOR OF STATE
Authorized Official:  ROBERT E. CLOVER  ASSISTANT SUPERINTENDENT  574-737-3611

Practice Location:
1098 S STATE ROAD 25  LOGANSPORT, IN 46947-6723 US
Tel: 574-722-4141  Fax: 574-735-3414

Business Mailing Address:
1098 S STATE ROAD 25  LOGANSPORT, IN 46947-6723 US
Tel: 574-722-4141  Fax: 574-735-3414

NPI Information:
NPI: 1376660027
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y3336I0012XSuppliers
Pharmacy
Institutional Pharmacy
IN60000531A

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 3336I0012X

Type:

Classification:



Definition:



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