Provider Demographics
NPI:1407180318
Name:BOOTH, JANET L
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:L
Last Name:BOOTH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 CONGRESSIONAL BLVD
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-5646
Mailing Address - Country:US
Mailing Address - Phone:317-818-1059
Mailing Address - Fax:317-818-1094
Practice Address - Street 1:801 CONGRESSIONAL BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-5646
Practice Address - Country:US
Practice Address - Phone:317-818-1059
Practice Address - Fax:317-818-1094
Is Sole Proprietor?:No
Enumeration Date:2009-09-24
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26022371A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist