NPIMap

Organization Active NPI

Purdue University

Doing business as Purdue University Pharmacy

  • Pharmacy
  • West Lafayette, IN
National Provider Identifier
1700876489
Registry record updated Sep 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
60000341A Issued in IN
Legal business name
PURDUE UNIVERSITY
Doing business as
Purdue University Pharmacy
Practice address
575 Stadium Mall Dr
Heine Pharmacy BLDG Room 118
West Lafayette, IN 47907-2091
Phone
(765) 496-7728
Fax
(765) 496-6094
NPI assigned
Oct 25, 2005
Last updated
Sep 26, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
PURDUE UNIVERSITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 26, 2025

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

Authorized official

Name
Hannah Carroll-Altman, JD
Title
Hipaa Privacy Officer
Phone
(765) 496-9059

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 60000341A IN Primary

Addresses

Primary practice location

575 Stadium Mall Dr
Heine Pharmacy BLDG Room 118
West Lafayette, IN 47907-2091

Mailing address

575 Stadium Mall Dr
Heine Pharmacy BLDG Room 118
West Lafayette, IN 47907-2091
Phone (765) 496-7728

Other identifiers 2

IdentifierTypeStateIssuer
60000341AOtherINHEALTH PROFESSIONS BUREAU
1514618OtherNABP

Other names 1

  • Purdue University Pharmacy Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D1031493Purdue Univ Pharmacy Apha-Asp575 Stadium Mall Dr, West Lafayette, IN 47907Certificate of waiverMay 22, 2028
15D2182692Purdue University Pharmacy575 Stadium Mall Drive, Room 118, West Lafayette, IN 47907Certificate of waiverApr 23, 2028

National Provider Directory

National Provider Directory
Tax ID family
Purdue University Student19 organizations share this tax ID, including this one
Part of
Purdue University Student

Other organizations with this tax ID 18

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

View all 18

Locations

575 Stadium Mall Dr
Rm 118
West Lafayette, IN 47907
Phone (765) 494-1374

NPI Registry JSON

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758844800000",
    "number": "1700876489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 STADIUM MALL DR",
            "address_2": "HEINE PHARMACY BLDG ROOM 118",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "479072091",
            "telephone_number": "765-496-7728",
            "fax_number": "765-496-6094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 STADIUM MALL DR",
            "address_2": "HEINE PHARMACY BLDG ROOM 118",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "479072091",
            "telephone_number": "765-496-7728",
            "fax_number": "765-496-6094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURDUE UNIVERSITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PURDUE UNIVERSITY",
        "enumeration_date": "2005-10-25",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A",
        "authorized_official_last_name": "CARROLL-ALTMAN",
        "authorized_official_first_name": "HANNAH",
        "authorized_official_title_or_position": "HIPAA PRIVACY OFFICER",
        "authorized_official_telephone_number": "765-496-9059",
        "authorized_official_credential": "JD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "IN",
            "license": "60000341A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PROFESSIONS BUREAU",
            "identifier": "60000341A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "1514618",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Purdue University Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.