Organization
INNOVATIVE RX, LLC
Active
Other names
Innovative Rx, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
AKRAM ABUMAHFOUZ (OWNER)
(317) 531-4985
Entity
Organization
Contact information
Practice address
11954 FISHERS CROSSING DR, FISHERS, IN 46038-2702
(317) 845-9820
Mailing address
11954 FISHERS CROSSING DR, FISHERS, IN 46038-2702
(317) 845-9820
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
60006415A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2148539
PK
—
Enumeration date
10/31/2014
Last updated
10/31/2014
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