VILLAGE APOTHECARY AT WILLIAMSBURG NPI 1043683568

NPI Information

NPI: 1043683568
Provider Name: VILLAGE APOTHECARY AT WILLIAMSBURG

Doing Business As: VILLAGE APOTHECARY AT WILLIAMSBURG

Classification: Pharmacy - 3336L0003X
Entity Type: Organization

Specialization: Long Term Care Pharmacy

Address:
1609 LAFAYETTE RD RM 23
CRAWFORDSVILLE, IN
ZIP 47933
Phone: (765) 364-0363
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VILLAGE APOTHECARY AT WILLIAMSBURG is a long term care pharmacy pharmacy in Crawfordsville, IN. The provider is a pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. VILLAGE APOTHECARY AT WILLIAMSBURG NPI is 1043683568. The provider is registered as an organization entity type.
The provider Is Doing Business As Village Apothecary At Williamsburg.

The provider's business location address is:

1609 LAFAYETTE RD RM 23
CRAWFORDSVILLE, IN
ZIP 47933-032
Phone: (765) 364-0363
Fax: (765) 362-2436

The provider's authorized official is Joseph Petricek .
The authorized official title is Pharmacist In Charge and has the following contact phone number (765) 364-0363.

The enumeration date for this NPI number is 11/5/2015 and was last updated on 9/30/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	332BX2000X	Durable Medical Equipment & Medical Supplies	Oxygen Equipment & Supplies			No
2	332BN1400X	Durable Medical Equipment & Medical Supplies	Nursing Facility Supplies			No
3	332B00000X	Durable Medical Equipment & Medical Supplies				No
4	333600000X	Pharmacy				No
5	3336L0003X	Pharmacy	Long Term Care Pharmacy	60006523A	INDIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	2155103	OTHER		PK
2	201348390A	MEDICAID	INDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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