Provider Demographics
NPI:1831139583
Name:ONNURI HEALTHCARE LLC
Entity Type:Organization
Organization Name:ONNURI HEALTHCARE LLC
Other - Org Name:PRANA PHARMACY AND HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUNGLAK
Authorized Official - Middle Name:
Authorized Official - Last Name:IM
Authorized Official - Suffix:
Authorized Official - Credentials:RPH MS
Authorized Official - Phone:317-663-3513
Mailing Address - Street 1:1130 W 86TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-2257
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1130 W 86TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-2257
Practice Address - Country:US
Practice Address - Phone:317-663-3513
Practice Address - Fax:317-663-3517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336C0003X, 3336H0001X
IN60005912A333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered333600000XSuppliersPharmacy
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Not Answered3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1560336OtherOTHER ID NUMBER-COMMERCIAL NUMBER
5554890001Medicare ID - Type Unspecified