Healthcare Provider Details

I. General information

NPI: 1538090600
Provider Name (Legal Business Name): RAMI IBRAHIM AL MAIS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3824 MAIN ST
ANDERSON IN
46013-4718
US

IV. Provider business mailing address

3505 FLETCHER ST
ANDERSON IN
46013-4670
US

V. Phone/Fax

Practice location:
  • Phone: 765-640-4398
  • Fax:
Mailing address:
  • Phone: 519-796-9607
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26031854A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: