Provider Demographics
NPI:1487678199
Name:SUMMERS, VEIGH LANCE (BS RPH)
Entity Type:Individual
Prefix:MR
First Name:VEIGH
Middle Name:LANCE
Last Name:SUMMERS
Suffix:
Gender:M
Credentials:BS RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9512 HOLLIDAY CIR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-1411
Mailing Address - Country:US
Mailing Address - Phone:317-574-1768
Mailing Address - Fax:317-816-9196
Practice Address - Street 1:9512 HOLLIDAY CIR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1411
Practice Address - Country:US
Practice Address - Phone:317-574-1768
Practice Address - Fax:317-816-9196
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL26091763A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist