David L Anderson, PHARMD.
Individual provider Active NPI Pharmacist · Shipshewana, IN
NPI 1295205102 · NPPES record last updated Dec 4, 2018
Key facts
- NPI
- 1295205102
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 26022099A (IN)
- Practice address
- 350 S Van Buren St Ste F
Shipshewana, IN 46565-9197 - Phone
- (260) 768-4433
- Fax
- (260) 768-4403
- NPI assigned
- Dec 4, 2018
- Sex
- Male
- 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 |
|---|---|---|---|
| 26022099A | IN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anderson Healthcare Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 26022099A | IN | Yes |
Addresses
Primary practice location
350 S Van Buren St Ste F
Shipshewana, IN 46565-9197
Mailing address
350 S Van Buren St Ste F
Shipshewana, IN 46565-9197
Phone (260) 768-4433
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 26022099A | Other | IN | PHARMACIST LICENSE |
Other providers in Shipshewana, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 4, 2018. 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.