Provider Demographics
NPI:1780916726
Name:SANDIDGE, OLIVIA ANN (PHARM D)
Entity type:Individual
Prefix:DR
First Name:OLIVIA
Middle Name:ANN
Last Name:SANDIDGE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:7557 SAINT GEORGE BLVD
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-1964
Mailing Address - Country:US
Mailing Address - Phone:317-288-5533
Mailing Address - Fax:317-962-2030
Practice Address - Street 1:1776 N MERIDIAN ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-1468
Practice Address - Country:US
Practice Address - Phone:317-962-5595
Practice Address - Fax:317-962-2030
Is Sole Proprietor?:No
Enumeration Date:2010-02-02
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26021498A1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist