Provider Demographics
NPI:1235856733
Name:HADLER, ELIZABETH MARION (RPH)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MARION
Last Name:HADLER
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 1:2510 SOLANA WAY UNIT 104
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-6018
Mailing Address - Country:US
Mailing Address - Phone:262-707-1161
Mailing Address - Fax:
Practice Address - Street 1:5005 E 56TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46226-1401
Practice Address - Country:US
Practice Address - Phone:317-254-8921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26029890A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist