Individual
VISHAL KUKREJA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1133 N EMERSON AVE, GREENWOOD, IN 46143-6275
(317) 885-9059
Mailing address
567 LEGACY BLVD, GREENWOOD, IN 46143-6427
(857) 544-3272
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
26023819A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26023819A
PHARMACIST LICENSE
IN
Enumeration date
07/16/2022
Last updated
07/16/2022
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