Provider Demographics
NPI:1548865314
Name:WINDROSE FAMILY PHARMACIES, LLC
Entity type:Organization
Organization Name:WINDROSE FAMILY PHARMACIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:K
Authorized Official - Last Name:ROLLETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-739-4895
Mailing Address - Street 1:1052 GREENWOOD SPRINGS BLVD STE H
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-6896
Mailing Address - Country:US
Mailing Address - Phone:317-739-4895
Mailing Address - Fax:
Practice Address - Street 1:5550 S EAST ST STE F
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-1991
Practice Address - Country:US
Practice Address - Phone:317-739-4895
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WINDROSE FAMILY PHARMACIES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy