NPIMap

Organization Active NPI

Indiana University Health Ball Memorial Hospital Inc

Doing business as IU Health Family Pharmacy

  • Community/Retail Pharmacy
  • Muncie, IN
National Provider Identifier
1457455404
Registry record updated Aug 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
60005307A Issued in IN
Legal business name
INDIANA UNIVERSITY HEALTH BALL MEMORIAL HOSPITAL INC
Doing business as
IU Health Family Pharmacy
Practice address
5501 W Bethel Ave
Muncie, IN 47304-8513
Phone
(765) 751-7900
Fax
(765) 747-2996
NPI assigned
Sep 12, 2006
Last updated
Aug 19, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2016

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

Authorized official

Name
Lori Luther
Title
Cfo
Phone
(765) 751-2795

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 60005307A IN Primary

Addresses

Primary practice location

5501 W Bethel Ave
Muncie, IN 47304-8513

Mailing address

1633 N Capitol Ave
Suite 438
Indianapolis, IN 46202-1261
Phone (317) 963-9730

Other identifiers 2

IdentifierTypeStateIssuer
1533707OtherNCPDP PROVIDER IDENTIFICATION NUMBER
200185540MedicaidIN

Other names 1

  • IU Health Family Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130124000278 IN Part B Supplier - Mass Immunization (Roster Biller Only) 5698688273 9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Yorktown, IN; Muncie, IN; Hartford City, IN

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471564800000",
    "number": "1457455404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1633 N CAPITOL AVE",
            "address_2": "SUITE 438",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021261",
            "telephone_number": "317-963-9730",
            "fax_number": "317-963-5003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 W BETHEL AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473048513",
            "telephone_number": "765-751-7900",
            "fax_number": "765-747-2996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA UNIVERSITY HEALTH BALL MEMORIAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2016-08-19",
        "status": "A",
        "authorized_official_last_name": "LUTHER",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "765-751-2795"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IN",
            "license": "60005307A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1533707",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200185540",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IU Health Family Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Muncie, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.