Diettrich Robert Hormann, PHARMD

Individual provider Active NPI Oncology Pharmacist · Whitestown, IN

NPI 1477339646 · NPPES record last updated Sep 5, 2023

Key facts

NPI
1477339646
Entity type
Individual (NPI type 1)
Primary specialty
Oncology Pharmacist 1835X0200X
License
26028009A (IN)
Practice address
4750 E 450 S
Whitestown, IN 46075-8404
Phone
(877) 732-3431
NPI assigned
Sep 5, 2023
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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

LicenseStateTypeSpecialty
26028009AINMDOncology Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Express Scripts Pharmacy Inc Current
since Sep 10, 2023
Accepting new patients

Locations

4750 E 450 S
Whitestown, IN 46075
Phone (866) 496-3326

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Oncology Pharmacist 1835X0200X 26028009A 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

All providers in Whitestown, IN · Oncology Pharmacist in Indiana

Sources for this page

Verify at the official NPI Registry.