Organization
VIRAG
Active
Other names
Thorntown Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAUMIIN CALCUTTAWALA PHARMD, MS (PHARMACIST IN CHARGE)
(317) 688-7050
Entity
Organization
Contact information
Practice address
151 E BOW STREET, INSIDE WITHAM CLINIC, THORNTOWN, IN 46071
(765) 889-4735
(765) 548-5736
Mailing address
1001 W MAIN ST, CARMEL, IN 46032-1433
(317) 688-7050
(317) 575-1094
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300040693
—
IN
Enumeration date
03/06/2020
Last updated
11/19/2021
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