Provider Demographics
NPI:1811622269
Name:BORDERS, RYAN ENNIS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:ENNIS
Last Name:BORDERS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5349 W PIKE PLAZA RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46254-3011
Mailing Address - Country:US
Mailing Address - Phone:317-387-2410
Mailing Address - Fax:317-387-2465
Practice Address - Street 1:5349 W PIKE PLAZA RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46254-3011
Practice Address - Country:US
Practice Address - Phone:317-387-2410
Practice Address - Fax:317-387-2410
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-20
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26029811A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist