Provider Demographics
NPI:1316602436
Name:FELLERS, CLAIRE (RPH)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:
Last Name:FELLERS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:888 E 66TH ST APT 408
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-0198
Mailing Address - Country:US
Mailing Address - Phone:317-504-2104
Mailing Address - Fax:
Practice Address - Street 1:474 SOUTHPOINT CIR
Practice Address - Street 2:
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112-2203
Practice Address - Country:US
Practice Address - Phone:317-858-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26029472A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist