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General NPI Number Information
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NPI Number | 1376816744
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Entity Type | Organization
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Legal Business Name | AFFORDABLE RX HEALTHMART & HOME MEDICAL EQUIPMENTS LLC
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Dates
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Enumeration Date | 02/16/2012
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Last Update Date | 07/29/2020
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Provider Practice Location Address
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Address Line | 1635 E SOUTHPORT RD
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City | INDIANAPOLIS
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State | IN
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Zip | 46227-5213
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Country | US
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Telephone | 317-879-5514
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Fax | 317-534-3776
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Provider Business Mailing Address
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Address Line | 1635 E SOUTHPORT RD
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City | INDIANAPOLIS
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State | IN
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Zip | 46227-5213
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Country | US
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Telephone | 317-879-5514
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Fax | 317-534-3776
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | OPE ADENIKE ISMAIL
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Credential | PHARM D
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Telephone | 131-787-9551
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 60006289A
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License Number State | IN
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