Active NPI
Blue River Pharmacy Inc
- Community/Retail Pharmacy
- Brownsburg, IN
National Provider Identifier
1164090825
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- BLUE RIVER PHARMACY INC
- Practice address
- 26 S Green St
Brownsburg, IN 46112-1251 - Phone
- (317) 286-3506
- Fax
- (317) 350-2917
- NPI assigned
- Jun 17, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Paul Cruzan
- Title
- President
- Phone
- (317) 286-3506
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Primary | ||
| Long Term Care Pharmacy | 3336L0003X |
Addresses
Primary practice location
26 S Green St
Brownsburg, IN 46112-1251
Mailing address
26 S Green St
Brownsburg, IN 46112-1251
Phone (317) 286-3506
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200914920A | Medicaid | IN |
Other names 1
- Blue River Pharmacy
National Provider Directory
National Provider Directory- Tax ID family
- Blue River Pharmacy
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Retail Pharmacy
- Brownsburg, IN
- NPI 1023268703
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Brownsburg, IN
- NPI 1174274732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623888000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1750809600000",
"number": "1164090825",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26 S GREEN ST",
"city": "BROWNSBURG",
"state": "IN",
"postal_code": "461121251",
"telephone_number": "317-286-3506",
"fax_number": "317-350-2917"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26 S GREEN ST",
"city": "BROWNSBURG",
"state": "IN",
"postal_code": "461121251",
"telephone_number": "317-286-3506",
"fax_number": "317-350-2917"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BLUE RIVER PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2021-06-17",
"last_updated": "2025-06-25",
"certification_date": "2025-06-25",
"status": "A",
"authorized_official_last_name": "CRUZAN",
"authorized_official_first_name": "PAUL",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "317-286-3506"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
},
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200914920A",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Blue River Pharmacy",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Blue River Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Brownsburg, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.