Healthcare Provider Details

I. General information

NPI: 1598215626
Provider Name (Legal Business Name): PHARMASAVE RX
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2016
Last Update Date: 10/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4638 S SCATTERFIELD RD
ANDERSON IN
46013-2900
US

IV. Provider business mailing address

4638 S SCATTERFIELD RD
ANDERSON IN
46013-2900
US

V. Phone/Fax

Practice location:
  • Phone: 765-374-3444
  • Fax:
Mailing address:
  • Phone: 765-374-3444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number60006581A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: GAMAL OKAB
Title or Position: PHARMACIST IN CHARGE
Credential:
Phone: 317-698-3934