Provider Demographics
NPI:1811575822
Name:VIRAG
Entity Type:Organization
Organization Name:VIRAG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:DR
Authorized Official - First Name:SAUMIIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CALCUTTAWALA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD, MS
Authorized Official - Phone:317-688-7050
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 1:151 E BOW STREET
Practice Address - Street 2:INSIDE WITHAM CLINIC
Practice Address - City:THORNTOWN
Practice Address - State:IN
Practice Address - Zip Code:46071
Practice Address - Country:US
Practice Address - Phone:765-889-4735
Practice Address - Fax:765-548-5736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-31
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No251G00000XAgenciesHospice Care, Community Based
No3336I0012XSuppliersPharmacyInstitutional Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300040693Medicaid