Provider Demographics
NPI:1902057698
Name:AMKAS LABORATORIES, INC.
Entity Type:Organization
Organization Name:AMKAS LABORATORIES, INC.
Other - Org Name:BIG TEN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:USHA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-659-5029
Mailing Address - Street 1:2075 INDIANAPOLIS BLVD
Mailing Address - Street 2:
Mailing Address - City:WHITING
Mailing Address - State:IN
Mailing Address - Zip Code:46394-1948
Mailing Address - Country:US
Mailing Address - Phone:219-659-5029
Mailing Address - Fax:219-659-5039
Practice Address - Street 1:2075 INDIANAPOLIS BLVD
Practice Address - Street 2:
Practice Address - City:WHITING
Practice Address - State:IN
Practice Address - Zip Code:46394-1948
Practice Address - Country:US
Practice Address - Phone:219-659-5029
Practice Address - Fax:219-659-5039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-01
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1562366OtherNCPDP PROVIDER IDENTIFICATION NUMBER