Provider Demographics
NPI:1619655289
Name:DERMODY, MORGAN LYNN (PHARMD, MBA)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:LYNN
Last Name:DERMODY
Suffix:
Gender:F
Credentials:PHARMD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4671 GRAND HAVEN LN APT E
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46280-2854
Mailing Address - Country:US
Mailing Address - Phone:618-334-4343
Mailing Address - Fax:
Practice Address - Street 1:13121 OLIO RD STE 300
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-7240
Practice Address - Country:US
Practice Address - Phone:317-355-6915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26029843A1835P1200X, 1835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy