Lisa Marlis Sandbo, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

26017201A Issued in IN

Practice address

342 Massachusetts Avenue
Suite 103
Indianapolis, IN 46204

Phone

(317) 631-6000

Fax

(317) 631-6004

NPI assigned

Dec 27, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1356566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356566400000",
    "number": "1255677944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 MASSACHUSETTS AVENUE",
            "address_2": "SUITE 103",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46204",
            "telephone_number": "317-631-6000",
            "fax_number": "317-631-6004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 MASSACHUSETTS AVENUE",
            "address_2": "SUITE 103",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46204",
            "telephone_number": "317-631-6000",
            "fax_number": "317-631-6004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDBO",
        "first_name": "LISA",
        "middle_name": "MARLIS",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-27",
        "last_updated": "2012-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26017201A",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "43798",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "43798",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "26017201A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Pharmacist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.