Provider Demographics
NPI:1104234830
Name:NORRIS, DAVID M (PHARMD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:NORRIS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:482 W NAVAJO ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:WEST LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47906-1940
Mailing Address - Country:US
Mailing Address - Phone:765-463-2600
Mailing Address - Fax:765-463-2601
Practice Address - Street 1:482 W NAVAJO ST STE A
Practice Address - Street 2:
Practice Address - City:WEST LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47906-1940
Practice Address - Country:US
Practice Address - Phone:765-463-2600
Practice Address - Fax:765-463-2601
Is Sole Proprietor?:No
Enumeration Date:2014-07-25
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26025604A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN26025604AOtherSTATE LICENSE