Healthcare Provider Details

I. General information

NPI: 1043812829
Provider Name (Legal Business Name): REHAM NAKHLA RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2020
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5718 CRAWFORDSVILLE RD
INDIANAPOLIS IN
46224-3704
US

IV. Provider business mailing address

2321 CHARLES ST
ANDERSON IN
46013-2762
US

V. Phone/Fax

Practice location:
  • Phone: 317-240-5007
  • Fax: 317-240-5008
Mailing address:
  • Phone: 765-642-5025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2602650A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: