Shakamak Health INC
Pharmacy, Community/Retail Pharmacy in Jasonville, IN. Organization (NPI-2).
NPI number1477815868
StatusActive
Last updated in NPPESJan 27, 2020
Details
- NPI
- 1477815868
- Entity type
- Organization (NPI-2)
- Legal business name
- Shakamak Health INC
- Organization subpart
- No
- Enumeration date
- Jun 12, 2012
- Certification date
- Jan 27, 2020
- Last updated
- Jan 27, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | 60006304A | IN | Yes |
| 333600000X | Pharmacy | – | – |
Other names
- Shakamak Pharmacy (Doing Business As)
Practice location
346 E Main StJasonville, IN 47438-1510
Phone 812-665-9760 · Fax 812-665-9762
Mailing address
346 E Main StJasonville, IN 47438-1510
Phone 812-665-9760 · Fax 812-665-9762
Authorized official
Traver Wolf
President Of Corporation
8126659760
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