Healthcare Provider Details

I. General information

NPI: 1376488601
Provider Name (Legal Business Name): AMIN MOHAMED PHARMACIST
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1203 S MAIN ST
BLUFFTON IN
46714-3904
US

IV. Provider business mailing address

13674 COPPER STRIKE PASS
FORT WAYNE IN
46845-0126
US

V. Phone/Fax

Practice location:
  • Phone: 260-824-1646
  • Fax: 260-824-1646
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number45025076A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: