Provider Demographics
NPI:1952068413
Name:BEKAS, NINA (RPH)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:
Last Name:BEKAS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:NINA
Other - Middle Name:
Other - Last Name:BEKAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:7622 REDCLIFF RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-3952
Mailing Address - Country:US
Mailing Address - Phone:317-414-7449
Mailing Address - Fax:
Practice Address - Street 1:5835 W 10TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46224-6112
Practice Address - Country:US
Practice Address - Phone:317-554-8963
Practice Address - Fax:317-243-2516
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-19
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26016001A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist