Provider Demographics
NPI:1528316908
Name:PHARMAKON PHARMACEUTICALS
Entity type:Organization
Organization Name:PHARMAKON PHARMACEUTICALS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:ELMER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:800-947-2711
Mailing Address - Street 1:801 CONGRESSIONAL BLVD STE 200B
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-5646
Mailing Address - Country:US
Mailing Address - Phone:800-947-2711
Mailing Address - Fax:
Practice Address - Street 1:801 CONGRESSIONAL BLVD STE 200B
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-5646
Practice Address - Country:US
Practice Address - Phone:800-947-2711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-16
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN60006167A/B3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN60006167AOtherINDIANA BOARD OF PHARMACY
IN60006167BOtherINDIANA BOARD OF PHARMACY