Provider Demographics
NPI:1386451698
Name:LAMPPERT, TRISTIAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TRISTIAN
Middle Name:
Last Name:LAMPPERT
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 1:23076 HAMBURG RD
Mailing Address - Street 2:
Mailing Address - City:OLDENBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47036-9752
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5543 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-6448
Practice Address - Country:US
Practice Address - Phone:317-359-8278
Practice Address - Fax:317-359-5939
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26030886A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist