Provider Demographics
NPI:1215224746
Name:WITTER, AIMEE L (RPH)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:L
Last Name:WITTER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 E 86TH ST STE 35
Mailing Address - Street 2:T-1848
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-1990
Mailing Address - Country:US
Mailing Address - Phone:317-810-0045
Mailing Address - Fax:317-810-0045
Practice Address - Street 1:1300 E 86TH ST STE 35
Practice Address - Street 2:T-1848
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-1990
Practice Address - Country:US
Practice Address - Phone:317-810-0045
Practice Address - Fax:317-810-0045
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-05
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26023907A183500000X
AK1845183500000X
VA0202011840183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist