Healthcare Provider Details

I. General information

NPI: 1457419186
Provider Name (Legal Business Name): LULU TANLU ZHU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4841 WINDRIFT WAY
CARMEL IN
46033-9508
US

IV. Provider business mailing address

4841 WINDRIFT WAY
CARMEL IN
46033-9508
US

V. Phone/Fax

Practice location:
  • Phone: 317-457-0230
  • Fax:
Mailing address:
  • Phone: 317-457-0230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26021237A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: