Provider Demographics
NPI:1346539087
Name:JANA, AMIT-KUMAR
Entity Type:Individual
Prefix:
First Name:AMIT-KUMAR
Middle Name:
Last Name:JANA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2011 W SHAW AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-3404
Mailing Address - Country:US
Mailing Address - Phone:559-224-0920
Mailing Address - Fax:559-225-0114
Practice Address - Street 1:2011 W SHAW AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3404
Practice Address - Country:US
Practice Address - Phone:559-224-0920
Practice Address - Fax:559-225-0114
Is Sole Proprietor?:No
Enumeration Date:2011-04-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH60363183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist