NPIMap

Organization Active NPI

Pharmobile LLC

  • Internal Medicine Physician
  • Pendleton, IN
National Provider Identifier
1669710893
Registry record updated Jun 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01047166A Issued in IN
Legal business name
PHARMOBILE LLC
Practice address
8975 S 800 W
Pendleton, IN 46064-9751
Phone
(317) 485-3117
Fax
(888) 322-9457
NPI assigned
Jan 23, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2013

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

Authorized official

Name
Dr. Brian Scott Jacobs, MD
Title
MBR
Phone
(317) 485-3117

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 01047166A IN Primary

Addresses

Primary practice location

8975 S 800 W
Pendleton, IN 46064-9751

Mailing address

8975 S 800 W
Pendleton, IN 46064-9751
Phone (317) 485-3117

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1358899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370217600000",
    "number": "1669710893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8975 S 800 W",
            "city": "PENDLETON",
            "state": "IN",
            "postal_code": "460649751",
            "telephone_number": "317-485-3117",
            "fax_number": "888-322-9457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8975 S 800 W",
            "city": "PENDLETON",
            "state": "IN",
            "postal_code": "460649751",
            "telephone_number": "317-485-3117",
            "fax_number": "888-322-9457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMOBILE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-23",
        "last_updated": "2013-06-03",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "MBR",
        "authorized_official_telephone_number": "317-485-3117",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01047166A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pendleton, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2013; 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.