Provider Demographics
NPI:1659867455
Name:CALCUTTAWALA, SAUMIIN (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:SAUMIIN
Middle Name:
Last Name:CALCUTTAWALA
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-1433
Mailing Address - Country:US
Mailing Address - Phone:317-688-7050
Mailing Address - Fax:317-575-1094
Practice Address - Street 1:1001 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-1433
Practice Address - Country:US
Practice Address - Phone:317-459-0536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-03
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26019540A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN26019540AOtherPHARMACIST LICENSE