Provider Demographics
NPI:1548045065
Name:ALIVIO PHARMACY, LLC
Entity type:Organization
Organization Name:ALIVIO PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:DURAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-346-4834
Mailing Address - Street 1:4010 W GOELLER BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47201-8312
Mailing Address - Country:US
Mailing Address - Phone:812-799-0589
Mailing Address - Fax:812-418-8710
Practice Address - Street 1:4010 W GOELLER BLVD STE C
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-8312
Practice Address - Country:US
Practice Address - Phone:812-799-0589
Practice Address - Fax:812-418-8710
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALIVIO PHARMACY COLUMBUS MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy