Provider Demographics
NPI:1134771868
Name:ROYSTON, DONALD ARTHUR (LICENSED PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:ARTHUR
Last Name:ROYSTON
Suffix:
Gender:M
Credentials:LICENSED PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2741 OGLETHORPE CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-1247
Mailing Address - Country:US
Mailing Address - Phone:317-370-7975
Mailing Address - Fax:
Practice Address - Street 1:6509 N KEYSTONE AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-1501
Practice Address - Country:US
Practice Address - Phone:317-253-7063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-12
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26012544A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist