Provider Demographics
NPI:1194560250
Name:NATALIES APOTHECARY INC
Entity type:Organization
Organization Name:NATALIES APOTHECARY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARTZEL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:765-237-3060
Mailing Address - Street 1:987 S CREASY LN
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47905-4800
Mailing Address - Country:US
Mailing Address - Phone:765-237-3060
Mailing Address - Fax:765-250-8586
Practice Address - Street 1:987 S CREASY LN
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-4800
Practice Address - Country:US
Practice Address - Phone:765-237-3060
Practice Address - Fax:765-250-8586
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATALIE'S APOTHECARY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-06-28
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300013403Medicaid