Provider Demographics
NPI:1376219030
Name:RYAN PLUS PHARMACY
Entity Type:Organization
Organization Name:RYAN PLUS PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KHOLOUD
Authorized Official - Middle Name:
Authorized Official - Last Name:ABU ZAID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-513-8570
Mailing Address - Street 1:2727 HIGHWAY AVE STE B
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:IN
Mailing Address - Zip Code:46322-1615
Mailing Address - Country:US
Mailing Address - Phone:219-513-8570
Mailing Address - Fax:
Practice Address - Street 1:2727 HIGHWAY AVE STE B
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:IN
Practice Address - Zip Code:46322-1615
Practice Address - Country:US
Practice Address - Phone:219-513-8570
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-20
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy