Mitchell Charles Fairbrother, RPh
Pharmacist in Indianapolis, IN. Individual provider (NPI-1).
NPI number1457955700
StatusActive
Last updated in NPPESNov 27, 2020
Details
- NPI
- 1457955700
- Entity type
- Individual (NPI-1)
- Name
- Mitchell Charles Fairbrother
- Credential
- RPh
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Nov 27, 2020
- Certification date
- Nov 27, 2020
- Last updated
- Nov 27, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 183500000X | Pharmacist | 26028582A | IN | Yes |
Practice location
8405 Southeastern AveIndianapolis, IN 46239-1348
Phone 317-862-2414
Mailing address
8405 Southeastern AveIndianapolis, IN 46239-1348
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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