Mercedes Clabaugh
Individual provider Active NPI Pharmacist · Whitestown, IN
NPI 1174200414 · NPPES record last updated Jun 29, 2023
Key facts
- NPI
- 1174200414
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 26028553A (IN)
- Practice address
- 4750 E 450 S
Whitestown, IN 46075-8404 - Phone
- (877) 732-3431
- NPI assigned
- Jun 29, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26028553A | IN | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 26028553A | IN | Yes |
Addresses
Primary practice location
4750 E 450 S
Whitestown, IN 46075-8404
Mailing address
4750 E 450 S
Whitestown, IN 46075-8404
Other providers in Whitestown, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 29, 2023. 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.