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NPI Code Detail

MEDICARE: TERESA SHAHSAVAR RPH

MEDICARE: TERESA SHAHSAVAR RPH
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
1183500000XPharmacist26017043AIN

General Provider Information

NPI Number : 1750880456
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERESA SHAHSAVAR RPH
Provider Business Mailing Address
First Line : 6330 E 75TH ST STE 322
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46250-2708
Country : US
Telephone Number : 800-678-7575
Fax Number :
Provider Business Practice Location Address
First Line : 6330 E 75TH ST STE 322
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46250-2708
Country : US
Telephone Number : 800-678-7575
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2018
Last Update Date : 02/08/2018

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Directions to “ TERESA SHAHSAVAR RPH” Practice Location

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