| Pharmobile Llc | |
|
8975 S 800 W Pendleton IN 46064-9751 | |
| (317) 485-3117 | |
| (888) 322-9457 |
| Full Name | Pharmobile Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 8975 S 800 W, Pendleton, Indiana |
| Authorized Official Name and Position | Brian Scott Jacobs (MBR) |
| Authorized Official Contact | 3174853117 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pharmobile Llc 8975 S 800 W Pendleton IN 46064-9751 Ph: (317) 485-3117 | Pharmobile Llc 8975 S 800 W Pendleton IN 46064-9751 Ph: (317) 485-3117 |
| NPI Number | 1669710893 |
|---|---|
| Provider Enumeration Date | 01/23/2013 |
| Last Update Date | 06/03/2013 |
| Medicare PECOS PAC ID | 0547409369 |
|---|---|
| Medicare Enrollment ID | O20130626000572 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669710893 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 01047166A (Indiana) | Primary |
| Provider Name | Brian S Jacobs |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588741060 PECOS PAC ID: 4082740675 Enrollment ID: I20100408000147 |
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