Active NPI
Marc David Krueger, PHARMD
- Pharmacist
- Indianapolis, IN
National Provider Identifier
1124304068
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 26022195A
- Practice address
- 9050 E 38TH St
Indianapolis, IN 46235-2004 - Phone
- (317) 898-9293
- Fax
- (317) 895-1871
- NPI assigned
- Oct 24, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 26022195A | IN | Primary |
Addresses
Primary practice location
9050 E 38TH St
Indianapolis, IN 46235-2004
Mailing address
1146 Ivy LN
Indianapolis, IN 46220-2657
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26022195A | IN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pharmacy
- Indianapolis, IN
- NPI 1013922145
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- Pharmacy
- Longview, TX
- NPI 1629956545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319414400000",
"number": "1124304068",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1146 IVY LN",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462202657"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9050 E 38TH ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462352004",
"telephone_number": "317-898-9293",
"fax_number": "317-895-1871"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRUEGER",
"first_name": "MARC",
"middle_name": "DAVID",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-10-24",
"last_updated": "2011-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IN",
"license": "26022195A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.