Provider Demographics
NPI:1306433909
Name:HALUDA, SHEILA (RPH)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:HALUDA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51594 WATERWATCH CT
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46628-9548
Mailing Address - Country:US
Mailing Address - Phone:574-274-9111
Mailing Address - Fax:
Practice Address - Street 1:926 ERSKINE PLZ
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46614-3244
Practice Address - Country:US
Practice Address - Phone:574-299-8844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26018955A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN26018955AOtherINDIANA BOARD OF PHARMACY