MEDICARE: LANA ADILEH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P1200X	Pharmacotherapy Pharmacist	26030226A	IN

General Provider Information

NPI Number	:	1265290407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LANA ADILEH

Provider Business Mailing Address
First Line	:	14243 KODIAK DR
Second Line	:
City	:	CARMEL
State	:	IN
Zip	:	46074-7757
Country	:	US
Telephone Number	:	847-630-3305
Fax Number	:

Provider Business Practice Location Address
First Line	:	5550 N KEYSTONE AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-3458
Country	:	US
Telephone Number	:	317-610-2210
Fax Number	:	317-205-8065

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2024
Last Update Date	:	03/12/2024

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Directions to “ LANA ADILEH ” Practice Location

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