Anita Lynn Lawrence, PHARMD
Individual provider Active NPI Pharmacist · Fortville, IN
NPI 1750984530 · NPPES record last updated Nov 16, 2020
Key facts
- NPI
- 1750984530
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 26020938A (IN)
- Practice address
- 715 E Broadway St
Fortville, IN 46040-1551 - Phone
- (317) 485-7111
- NPI assigned
- Nov 16, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
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
| License | State | Type | Specialty |
|---|---|---|---|
| 26020938A | IN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hook-Superx LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 26020938A | IN | Yes |
Addresses
Primary practice location
715 E Broadway St
Fortville, IN 46040-1551
Mailing address
4841 E 71St St
Indianapolis, IN 46220-3889
Phone (317) 442-6784
Other providers in Fortville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.