Healthcare Provider Details

I. General information

NPI: 1629998257
Provider Name (Legal Business Name): CHAZ ARTHUR ROACH PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1606 N 7TH ST
TERRE HAUTE IN
47804-2706
US

IV. Provider business mailing address

930 S 34TH ST
TERRE HAUTE IN
47803-2308
US

V. Phone/Fax

Practice location:
  • Phone: 812-238-4935
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26031370A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: