Provider Demographics
NPI:1275181281
Name:LARATTA, KAREN S (RPH)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:S
Last Name:LARATTA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:S
Other - Last Name:HASSELBRING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:10705 MIDNIGHT DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46239-9160
Mailing Address - Country:US
Mailing Address - Phone:317-517-2105
Mailing Address - Fax:
Practice Address - Street 1:10617 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46229-2611
Practice Address - Country:US
Practice Address - Phone:317-895-0316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-03
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26014751A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist