Provider Demographics
NPI:1528566767
Name:ELI LILLY AND COMPANY PHARMACY
Entity Type:Organization
Organization Name:ELI LILLY AND COMPANY PHARMACY
Other - Org Name:ELI LILLY AND COMPANY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:KARYN
Authorized Official - Middle Name:
Authorized Official - Last Name:KWAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-276-3827
Mailing Address - Street 1:LILLY CORPORATE CENTER
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46285-0001
Mailing Address - Country:US
Mailing Address - Phone:317-276-3827
Mailing Address - Fax:317-276-1733
Practice Address - Street 1:LILLY CORPORATE CENTER
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46285-0001
Practice Address - Country:US
Practice Address - Phone:317-276-3827
Practice Address - Fax:317-276-1733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-23
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
IN6000441A3336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2175414OtherPK