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LIFESPAN PHARMACY LLC

Long Term Care Pharmacy

A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.

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Contact Information

LIFESPAN PHARMACY LLC
9900 WESTPOINT DRIVE
SUITE 100
INDIANAPOLIS, IN  46256-3358
 Phone: 317-841-0388
 Fax: 317-841-0733
 Website:
 

Specialty

 Taxonomy Code Specialty Code Provider Type

Long Term Care Pharmacy

 3336L0003X 58 Medical Supply Company with Pharmacist
 

Institutional Pharmacy

 3336I0012X 58 Medical Supply Company with Pharmacist
 

Pharmacy

 333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for LIFESPAN PHARMACY LLC

NPI Number 1093968448
LBN Legal business name LIFESPAN PHARMACY LLC
Authorized official KATHY HEADLEY - (CHAIRPERSON OF THE BOARD)
Entity Organization
Organization subpart 1 No
Enumeration date 10/29/2008
Last updated 02/16/2023 - About 3 years ago
Identifiers
IN License # 600061169B
IN Medicaid 200925240
IN Medicaid 200925240A
Other 2117622 PK
IN Other 60006848B CSR-PHARMACY
IN Other 60006848A PHARMACY LICENSE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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