GRIFFIN BROADMOOR PHARMACY INC (NPI# 1912992033) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912992033 |
| Entity Type | Organization |
| Organization Name | GRIFFIN BROADMOOR PHARMACY INC |
| Other Organization Name | BROADMOOR PHARMACY |
| Practice Address |
110 Ridge Rd Munster IN 46321-1520 |
| Practice Telephone | 2198368585 |
| Practice Fax Number | 2198365657 |
| Mailing Telephone | 2198368585 |
| Mailing Fax Number | 2198365657 |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. JOHN J GRIFFIN (PRESIDENT) |
| Authorized Official Telephone | 2198368585 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 60003614A | IN | Pharmacy Service Providers |
| Other Name | Type Code |
|---|---|
| Broadmoor Pharmacy | Doing Business As Name - Organization |
| Street Address |
110 RIDGE RD |
| City | MUNSTER |
| State | IN |
| Zip Code | 46321-1520 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447250576 | Madhavi K. Cherukuri | Obstetrics & Gynecology | 110 Ridge Rd, Munster, IN 46321-1574 | 2005-07-29 |
| 1356573778 | Northwest Indiana Pain Services | Anesthesiology | 110 Ridge Rd, Suite # 3, Munster, IN 46321-1574 | 2009-08-18 |
| 1104093640 | Womens Medical Care LLC | Obstetrics & Gynecology | 110 Ridge Rd, Munster, IN 46321-1574 | 2008-05-14 |
| 1184830168 | Manmohan Singh M.d. P.C. | Orthopaedic Surgery | 110 Ridge Rd, Suite 11, Munster, IN 46321-1520 | 2007-05-15 |
| 1134175490 | Illiana Surgery and Medical Center | Physical Therapist | 110 Ridge Rd, Munster, IN 46321-1520 | 2006-05-26 |
| 1437159563 | Durga R. Kanuru | Obstetrics & Gynecology | 110 Ridge Rd, Munster, IN 46321-1574 | 2005-07-29 |
| 1477553501 | Henry M. Zuniga | Obstetrics & Gynecology | 110 Ridge Rd, Suite 2, Munster, IN 46321-1574 | 2005-07-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154959179 | Munster Surgery Center LLC | Clinic/Center | 1950 45thstreet, Unit 101, Munster, IN 46321 | 2020-03-27 |
| 1467092668 | Barbara Armstrong-whitaker | Counselor | 8855 Columbia Ave, Munster, IN 46321 | 2020-01-15 |
| 1427537661 | Courtney Szydelko | Physical Therapist | 759 45th St Ste 202, Munster, IN 46321 | 2018-08-08 |
| 1407341787 | New Harvest Therapy Services, Inc. | Clinic/Center | 8124 Calumet Ave Ste B, Munster, IN 46321 | 2018-06-28 |
| 1043717945 | Region Eye Care LLC | Optometrist | 10413 Calumet Ave., Munster, IN 46321 | 2018-04-09 |
| 1003318122 | Jean M Nanos | Psychologist | 8124 Calumet Ave, Munster, IN 46321 | 2018-03-05 |
| 1841706330 | Avalon Marciniak | Speech-Language Pathologist | 1950 West 45th St., Munster, IN 46321 | 2017-12-19 |
| 1104330034 | Hinsdale Orthopaedic Associates, S.c. | Orthopaedic Surgery | 8141 S Calumet Ave, Unit 1, Munster, IN 46321 | 2017-11-30 |
| 1457871774 | Shannon Nicole Riley | Behavior Technician | 8113 Howard Ave., Munster, IN 46321 | 2017-06-27 |
| 1679017313 | Infomedica | Internal Medicine | 10010 Donald S Powers Dr, Munster, IN 46321 | 2016-12-15 |
| Find all providers in zip 46321 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083115984 | Lora Lacey | Pharmacist | 801 Macarthur Blvd Ste 102, Munster, IN 46321-2916 | 2018-02-26 |
| 1932614187 | Elizabeth Ann Clements | Pharmacist | 901 Macarthur Blvd Dept Of, Munster, IN 46321-2901 | 2017-12-11 |
| 1851749006 | Milana Dragutinovich | Pharmacist | 740 Ridge Rd, Munster, IN 46321-1612 | 2016-05-27 |
| 1275935041 | Malhar C Desai | Pharmacist | 9802 Wildwood Cir, Apt 1d, Munster, IN 46321-3982 | 2014-09-23 |
| 1548672421 | Christine Dinatale | Pharmacist | 9054 Columbia Ave Ste A, Munster, IN 46321-2905 | 2014-05-27 |
| 1619240611 | James Joseph Wachel | Pharmacist | 8516 Monroe Ave, Munster, IN 46321-2308 | 2012-02-22 |
| 1790986743 | Ivan M Kaplan | Pharmacist | 9466 Calumet Ave, Munster, IN 46321-2812 | 2007-05-29 |
| 1033710561 | Jonathan Chua | Pharmacist | 901 Macarthur Blvd, Munster, IN 46321-2901 | 2020-11-02 |
| 1497360218 | Lisander Vainiko | Pharmacist | 716 Ridge Rd, Munster, IN 46321-1612 | 2020-09-09 |
| 1942812391 | Cathrine Roels | Pharmacist | 901 Macarthur Blvd, Munster, IN 46321-2901 | 2020-08-18 |
| Find all providers in MUNSTER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.