Deidre Elizondo, RPH
Individual provider Active NPI Pharmacist · Whitestown, IN
NPI 1760722003 · NPPES record last updated Jun 24, 2024
Key facts
- NPI
- 1760722003
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 26020262A (IN)
- Practice address
- 4750 E 450 S Ste a
Whitestown, IN 46075-8404 - Phone
- (317) 652-2609
- NPI assigned
- Feb 24, 2013
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26020262A | IN | MD | Oncology Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 26020262A | IN | Yes |
| Oncology Pharmacist | 1835X0200X | 26020262A | IN |
Addresses
Primary practice location
4750 E 450 S Ste a
Whitestown, IN 46075-8404
Mailing address
13579 E 131St St
Fishers, IN 46037-6303
Phone (317) 652-2609
Other practice location 1
11455 N Meridian St
Carmel, IN 46032-1624
Phone (317) 652-2609
Other providers in Whitestown, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2024. 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.