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State of Indiana Auditor of State

Organization Active NPI Institutional Pharmacy · Madison, IN

NPI 1477596757 · NPPES record last updated Dec 3, 2015

Key facts

NPI
1477596757
Entity type
Organization (NPI type 2)
Primary specialty
Institutional Pharmacy 3336I0012X
License
60000778A (IN)
Legal business name
STATE OF INDIANA AUDITOR OF STATE
Practice address
711 Green Rd
Madison, IN 47250-2143
Phone
(812) 265-7460
Fax
(812) 265-7463
NPI assigned
Jun 14, 2006
Organization subpart
No

Authorized official

Name
Timothy Palmer
Title
Dir of Phcy
Phone
(812) 265-7461

Corporate family (same tax ID) 31

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

View all 31

National Provider Directory

Tax ID family
State of Indiana Auditor of State (32 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Institutional Pharmacy 3336I0012X 60000778A IN Yes

Addresses

Primary practice location

711 Green Rd
Madison, IN 47250-2143

Mailing address

711 Green Rd
Madison, IN 47250-2143
Phone (812) 265-7460

Other identifiers

IdentifierTypeStateIssuer
100272180AMedicaidIN
2024923OtherPK
100273320AMedicaidIN
200829500AMedicaidIN

Other names

  • MADISON ST HOSPITAL PHARMACY Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 3, 2015.

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449100800000",
    "number": "1477596757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 GREEN RD",
            "city": "MADISON",
            "state": "IN",
            "postal_code": "472502143",
            "telephone_number": "812-265-7460",
            "fax_number": "812-265-7463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 GREEN RD",
            "city": "MADISON",
            "state": "IN",
            "postal_code": "472502143",
            "telephone_number": "812-265-7460",
            "fax_number": "812-265-7463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF INDIANA AUDITOR OF STATE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2015-12-03",
        "status": "A",
        "authorized_official_last_name": "PALMER",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "DIR OF PHCY",
        "authorized_official_telephone_number": "812-265-7461"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "IN",
            "license": "60000778A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100272180A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2024923",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100273320A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200829500A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MADISON ST HOSPITAL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Madison, IN

All providers in Madison, IN · Institutional Pharmacy in Indiana

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