Provider Demographics
NPI:1437580529
Name:EATON, LYMAN II (RPH)
Entity Type:Individual
Prefix:MR
First Name:LYMAN
Middle Name:
Last Name:EATON
Suffix:II
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10119 HAMILTON HILLS LN
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-2059
Mailing Address - Country:US
Mailing Address - Phone:317-989-7555
Mailing Address - Fax:
Practice Address - Street 1:8250 BASH ST STE D
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-1938
Practice Address - Country:US
Practice Address - Phone:888-440-7117
Practice Address - Fax:888-296-7196
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26013229A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN26013229AOtherBOARD OF PHARMACY