Provider Demographics
NPI:1366710287
Name:DELICH, CINDY LEE (RPH)
Entity type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:LEE
Last Name:DELICH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10216 NEW HAMPSHIRE ST
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-8552
Mailing Address - Country:US
Mailing Address - Phone:219-663-8816
Mailing Address - Fax:
Practice Address - Street 1:1520 S COURT ST
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-4809
Practice Address - Country:US
Practice Address - Phone:219-663-0336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-06
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26020522A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist