NPIMap

Organization Active NPI

State of Indiana, Auditor of State

Doing business as Logansport State Hospital,

  • Institutional Pharmacy
  • Logansport, IN
National Provider Identifier
1376660027
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Institutional PharmacyTaxonomy code 3336I0012X
License
60000531A Issued in IN
Legal business name
STATE OF INDIANA, AUDITOR OF STATE
Doing business as
Logansport State Hospital,
Practice address
1098 S State Road 25
Logansport, IN 46947-6723
Phone
(574) 722-4141
Fax
(574) 735-3414
NPI assigned
Mar 26, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Robert E. Clover
Title
Assistant Superintendent
Phone
(574) 737-3611

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Institutional Pharmacy 3336I0012X 60000531A IN Primary

Addresses

Primary practice location

1098 S State Road 25
Logansport, IN 46947-6723

Mailing address

1098 S State Road 25
Logansport, IN 46947-6723
Phone (574) 722-4141

Other names 1

  • Logansport State Hospital, Doing business as

National Provider Directory

National Provider Directory
Tax ID family
State Board of Health32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

Organizations that report the same tax identification number in the National Provider Directory.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376660027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1098 S STATE ROAD 25",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469476723",
            "telephone_number": "574-722-4141",
            "fax_number": "574-735-3414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1098 S STATE ROAD 25",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469476723",
            "telephone_number": "574-722-4141",
            "fax_number": "574-735-3414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF INDIANA, AUDITOR OF STATE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CLOVER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "ASSISTANT SUPERINTENDENT",
        "authorized_official_telephone_number": "574-737-3611",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "IN",
            "license": "60000531A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Logansport State Hospital,",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Logansport, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.