Provider Demographics
NPI:1407946536
Name:WEBB'S FAMILY PHARMACY LLC
Entity Type:Organization
Organization Name:WEBB'S FAMILY PHARMACY LLC
Other - Org Name:WEBB'S FAMILY PHARMACY #2
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:PD
Authorized Official - Phone:574-893-4413
Mailing Address - Street 1:PO BOX 278
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:IN
Mailing Address - Zip Code:46910-0278
Mailing Address - Country:US
Mailing Address - Phone:574-893-4413
Mailing Address - Fax:574-893-7911
Practice Address - Street 1:100 E ROCHESTER ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:IN
Practice Address - Zip Code:46910-9997
Practice Address - Country:US
Practice Address - Phone:574-893-4413
Practice Address - Fax:574-893-7911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2016-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
IN600048493336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
1506469OtherNCPDP
IN60004849OtherINDIANA PHARMACY PERMIT
IN100295900Medicaid
IN60004849OtherINDIANA PHARMACY PERMIT