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General NPI Number Information
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NPI Number | 1043170541
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Entity Type | Organization
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Legal Business Name | BLOOM RX PHARMACY
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Dates
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Enumeration Date | 11/17/2025
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Last Update Date | 01/15/2026
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Provider Practice Location Address
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Address Line | 465 N TOWN CENTER RD
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City | MOORESVILLE
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State | IN
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Zip | 46158-2316
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Country | US
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Telephone | 317-289-0326
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Fax |
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Provider Business Mailing Address
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Address Line | 465 N TOWN CENTER RD
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City | MOORESVILLE
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State | IN
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Zip | 46158-2316
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Country | US
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Telephone | 317-345-4147
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Fax | 317-584-3014
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Authorized Official
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Title or Position | OWNER/PHARMACIST IN CHARGE
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Name | MUSTAFA NAIEM AHMED
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Credential | RPH
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Telephone | 317-289-0326
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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