Organization
AMRUT JAL LLC
Active
Other names
HOOSIERS PRESCRIPTION SHOP
Organization subpart
No
Provider details
NPI number
Authorized official
ASHOK PATEL (OWNER/PHARMACIST)
(812) 229-0454
Entity
Organization
Contact information
Practice address
3020 S 7TH ST, TERRE HAUTE, IN 47802-3902
(812) 232-9646
(812) 232-9647
Mailing address
88 SOUTHGATE CT, TERRE HAUTE, IN 47802-4975
(812) 229-0454
(812) 232-9647
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
60006258A
IN
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1563382
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/11/2011
Last updated
07/11/2011
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