NPIMap

Organization Active NPI

Indiana University Health Center

  • Community/Retail Pharmacy
  • Bloomington, IN
National Provider Identifier
1619079191
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
60001312A Issued in IN
Legal business name
INDIANA UNIVERSITY HEALTH CENTER
Practice address
600 N Jordan Ave
Bloomington, IN 47405-3190
Phone
(812) 855-3865
Fax
(812) 856-7777
NPI assigned
Sep 4, 2006
Last updated
Mar 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2022

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

Authorized official

Name
Mr. Michael C Mitchell, RPHNPI 1730229089
Title
Pharmacy Director
Phone
(812) 855-3865

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 60001312A IN Primary

Addresses

Primary practice location

600 N Jordan Ave
Bloomington, IN 47405-3190

Mailing address

600 N Eagelson Ave
Bloomington, IN 47405-3190
Phone (812) 855-3865

Other identifiers 2

IdentifierTypeStateIssuer
1509667OtherNABP
60001312AOtherININ LICENSE

National Provider Directory

National Provider Directory
Tax ID family
Indianapolis Eye Care C27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

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

View all 26

Locations

600 N Eagleson Ave
Bloomington, IN 47405
Phone (812) 855-3865

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1157328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646697600000",
    "number": "1619079191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N EAGELSON AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474053190",
            "telephone_number": "812-855-3865",
            "fax_number": "812-856-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N JORDAN AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474053190",
            "telephone_number": "812-855-3865",
            "fax_number": "812-856-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA UNIVERSITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-04",
        "last_updated": "2022-03-08",
        "certification_date": "2022-02-22",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PHARMACY DIRECTOR",
        "authorized_official_telephone_number": "812-855-3865",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IN",
            "license": "60001312A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "1509667",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IN LICENSE",
            "identifier": "60001312A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; 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.