Provider Demographics
NPI:1962783423
Name:HAMANN, ANDREA ELAINE (PHARMD)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:ELAINE
Last Name:HAMANN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:ELAINE
Other - Last Name:SANDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:209 W 46TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46208-3545
Mailing Address - Country:US
Mailing Address - Phone:317-407-3277
Mailing Address - Fax:
Practice Address - Street 1:5580 GEORGETOWN RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46254-3710
Practice Address - Country:US
Practice Address - Phone:317-297-1777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-29
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26022849A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist