Provider Demographics
NPI:1861488124
Name:APOTHERCARY SOLUTIONS CORPORATION
Entity Type:Organization
Organization Name:APOTHERCARY SOLUTIONS CORPORATION
Other - Org Name:HOMEMED LTC PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:317-616-4513
Mailing Address - Street 1:6210 TECHNOLOGY CENTER DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46278-6003
Mailing Address - Country:US
Mailing Address - Phone:317-616-4500
Mailing Address - Fax:317-616-4521
Practice Address - Street 1:6210 TECHNOLOGY CENTER DR
Practice Address - Street 2:SUITE 200
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46278-6003
Practice Address - Country:US
Practice Address - Phone:317-616-4500
Practice Address - Fax:317-616-4521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN60005759A333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1536816OtherNABP
IN60005759AOtherSTATE PERMIT
IN49373001Medicare ID - Type UnspecifiedMEDICARE