Organization
LOCAL HEALTH INDIANA INC.
Active
Other names
DBA Bristol Pharmacy Former Name Jai Chamunda Inc
Organization subpart
No
Provider details
NPI number
Authorized official
SELMA DZELIL PHARMD. (VP RDO)
(815) 715-8502
Entity
Organization
Contact information
Practice address
300 E ELKHART, BRISTOL, IN 46507
(815) 715-8502
(574) 848-0663
Mailing address
300 E ELKHART, BRISTOL, IN 46507
(815) 715-8502
(574) 848-0663
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
60005839A
IN
333600000X
Pharmacy
60005839A
IN
3336C0003X
Community/Retail Pharmacy
Primary
60005839A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1537135
NCPDP
—
05
—
200126860A
—
IN
Enumeration date
09/11/2006
Last updated
04/16/2024
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