Provider Demographics
NPI:1568744340
Name:PRIAR, JANICE
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:PRIAR
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 1:597 NORTHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46168-3035
Mailing Address - Country:US
Mailing Address - Phone:317-294-7248
Mailing Address - Fax:
Practice Address - Street 1:597 NORTHFIELD RD
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IN
Practice Address - Zip Code:46168-3035
Practice Address - Country:US
Practice Address - Phone:317-294-7248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26018557A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist