Provider Demographics
NPI:1609205681
Name:NRS PHARMACIES OF INDIANA LLC
Entity Type:Organization
Organization Name:NRS PHARMACIES OF INDIANA LLC
Other - Org Name:LIBERTY MEDICENTER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHEIBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-965-4700
Mailing Address - Street 1:10 S MAIN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:LIBERTY
Mailing Address - State:IN
Mailing Address - Zip Code:47353-1341
Mailing Address - Country:US
Mailing Address - Phone:765-223-2121
Mailing Address - Fax:765-223-2029
Practice Address - Street 1:10 S MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:IN
Practice Address - Zip Code:47353-1341
Practice Address - Country:US
Practice Address - Phone:765-223-2121
Practice Address - Fax:765-223-2029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-11
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN60006358A3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2142953OtherPK