Provider Demographics
NPI:1669981528
Name:PHARMARAJ PHARMACY SERVICES
Entity type:Organization
Organization Name:PHARMARAJ PHARMACY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:FATAI
Authorized Official - Middle Name:ADEMOLA
Authorized Official - Last Name:RAJI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARND
Authorized Official - Phone:317-850-4299
Mailing Address - Street 1:1385 DANIELLE DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46231-1614
Mailing Address - Country:US
Mailing Address - Phone:317-850-4299
Mailing Address - Fax:
Practice Address - Street 1:1385 DANIELLE DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46231-1614
Practice Address - Country:US
Practice Address - Phone:317-850-4299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26021841A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty