Provider Demographics
NPI:1184228066
Name:COLE, DARRELL F II (RPH)
Entity Type:Individual
Prefix:MR
First Name:DARRELL
Middle Name:F
Last Name:COLE
Suffix:II
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:D
Other - Middle Name:FRANK
Other - Last Name:COLE
Other - Suffix:II
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:200 S HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46176-2160
Mailing Address - Country:US
Mailing Address - Phone:317-398-9791
Mailing Address - Fax:
Practice Address - Street 1:200 S HARRISON ST
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:IN
Practice Address - Zip Code:46176-2160
Practice Address - Country:US
Practice Address - Phone:317-519-3492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26015822A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist