Healthcare Provider Details

I. General information

NPI: 1598786550
Provider Name (Legal Business Name): CELAMAR CORP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 04/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 MACARTHUR BLVD STE 31
MUNSTER IN
46321-2917
US

IV. Provider business mailing address

800 MACARTHUR BLVD STE 31
MUNSTER IN
46321-2917
US

V. Phone/Fax

Practice location:
  • Phone: 219-836-9950
  • Fax: 219-836-9951
Mailing address:
  • Phone: 219-836-9950
  • Fax: 219-836-9951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number60005657A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DANIEL ZURAWSKI
Title or Position: CEO
Credential:
Phone: 219-836-9950