Provider Demographics
NPI:1487161154
Name:PERRAS, CASSIE ANNE (PHARMD)
Entity type:Individual
Prefix:
First Name:CASSIE
Middle Name:ANNE
Last Name:PERRAS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 N MAIN ST PO BOX 357
Mailing Address - Street 2:
Mailing Address - City:CLOVERDALE
Mailing Address - State:IN
Mailing Address - Zip Code:46120
Mailing Address - Country:US
Mailing Address - Phone:765-795-4100
Mailing Address - Fax:765-795-5310
Practice Address - Street 1:900 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CLOVERDALE
Practice Address - State:IN
Practice Address - Zip Code:46120
Practice Address - Country:US
Practice Address - Phone:765-795-4100
Practice Address - Fax:765-795-5310
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-04
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26027145A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist