Odon Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

60003675A Issued in IN

Legal business name

ODON PHARMACY LLC

Doing business as

Odon Pharmacy

Practice address

200 W Main St
Odon, IN 47562-1218

Phone

(812) 636-4600

Fax

(812) 636-8004

NPI assigned

Jun 16, 2006

Last updated

Oct 27, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kenneth Holland, RPH

Title

Owner,Pic,Ao

Phone

(812) 636-4600

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• ODON PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in IN2 enrollments

Enrollment records 2

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

Medicare medical equipment & supply locations

Locations

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.

• Blane Lawyer

  • Pharmacist
  • Odon, IN
  • NPI 1093317315
  NPD

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445904000000",
    "number": "1952345159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 355",
            "city": "ODON",
            "state": "IN",
            "postal_code": "475620355",
            "telephone_number": "812-636-4600",
            "fax_number": "812-636-8004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W MAIN ST",
            "city": "ODON",
            "state": "IN",
            "postal_code": "475621218",
            "telephone_number": "812-636-4600",
            "fax_number": "812-636-8004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODON PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-16",
        "last_updated": "2015-10-27",
        "status": "A",
        "authorized_official_last_name": "HOLLAND",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "OWNER,PIC,AO",
        "authorized_official_telephone_number": "812-636-4600",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IN",
            "license": "60003675A",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2026659",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100294700A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ODON PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• MC Ambulance Service, LLC.
• Lisa K Menefee, D.D.S.
• Mendy L Mullis, C-PA
• David M Nibel, MD
• Odon Optical, Inc.
• Richard A Potts, DO
• Melissa L Reintjes, NP-C
• Daniell M Summers, NP
• Truth Counseling LLC (Truth Counseling)
• Wellnessfirst Chiropractic of Odon

• Community/Retail Pharmacy in Odon, IN
• Providers in Odon, IN by specialty
• Community/Retail Pharmacy in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.