Victoria R Gavin, PHARMD
Individual provider Active NPI Pharmacist · Huntingburg, IN
NPI 1164026886 · NPPES record last updated Nov 23, 2020
Key facts
- NPI
- 1164026886
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 26026736A (IN)
- Practice address
- 610 N Main St
Huntingburg, IN 47542-1044 - Phone
- (812) 683-3309
- NPI assigned
- Nov 23, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26026736A | IN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hook-Superx LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 26026736A | IN | Yes |
Addresses
Primary practice location
610 N Main St
Huntingburg, IN 47542-1044
Mailing address
6596 S State Road 161
Huntingburg, IN 47542-8955
Phone (618) 798-0609
Other providers in Huntingburg, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 23, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.