Individual
DR. JEREMY COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
4901 STATE ROAD 26 E, LAFAYETTE, IN 47905-4611
(765) 449-9233
Mailing address
4901 STATE ROAD 26 E, LAFAYETTE, IN 47905-4611
(765) 449-9233
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
26025014A
IN
Other
Enumeration date
05/19/2014
Last updated
05/19/2014
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