Provider Demographics
NPI:1457496192
Name:TOTAL HEALTH PARTNERS INC
Entity Type:Organization
Organization Name:TOTAL HEALTH PARTNERS INC
Other - Org Name:MEDICINE SHOPPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:219-885-1615
Mailing Address - Street 1:1116 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:GARY
Mailing Address - State:IN
Mailing Address - Zip Code:46402-1307
Mailing Address - Country:US
Mailing Address - Phone:219-885-1615
Mailing Address - Fax:219-885-1738
Practice Address - Street 1:1116 BROADWAY
Practice Address - Street 2:
Practice Address - City:GARY
Practice Address - State:IN
Practice Address - Zip Code:46402-1307
Practice Address - Country:US
Practice Address - Phone:219-885-1615
Practice Address - Fax:219-885-1738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN600054223336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1534228OtherNABP
IN1534228OtherNABP
INBT6212106OtherDEA #