Provider Demographics
NPI:1669095261
Name:ABI WESTEND PHARMACY
Entity type:Organization
Organization Name:ABI WESTEND PHARMACY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ABIMBOLA
Authorized Official - Middle Name:A
Authorized Official - Last Name:AKIWOWO
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:317-414-1377
Mailing Address - Street 1:9678 SUMMERLAKES DR
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-9393
Mailing Address - Country:US
Mailing Address - Phone:317-414-1377
Mailing Address - Fax:
Practice Address - Street 1:855 N HIGH SCHOOL RD STE 9
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46214-5702
Practice Address - Country:US
Practice Address - Phone:317-414-1377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MONYET LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-05-19
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy