Individual
KHWAJA HARIS AHMED TALHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1301 S ADAMS ST APT 20, BLOOMINGTON, IN 47403-2197
(443) 388-3960
Mailing address
1301 S ADAMS ST APT 20, BLOOMINGTON, IN 47403-2197
(443) 388-3960
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26030031A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W265140758
AETNA
—
Enumeration date
10/26/2022
Last updated
10/26/2022
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