Healthcare Provider Details

I. General information

NPI: 1245639640
Provider Name (Legal Business Name): RAMANDEEP SOHI PHARMD, MBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2014
Last Update Date: 10/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5020 GRAPE RD
MISHAWAKA IN
46545-8708
US

IV. Provider business mailing address

5020 GRAPE RD
MISHAWAKA IN
46545-8708
US

V. Phone/Fax

Practice location:
  • Phone: 574-273-3510
  • Fax:
Mailing address:
  • Phone: 574-273-3510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03233627-2
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302046429
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26027524A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: