Provider Demographics
NPI:1336495647
Name:KULAK, ROBERT ANDREW (RPH)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:ANDREW
Last Name:KULAK
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7033 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-1027
Mailing Address - Country:US
Mailing Address - Phone:317-602-4025
Mailing Address - Fax:
Practice Address - Street 1:7033 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-1027
Practice Address - Country:US
Practice Address - Phone:317-602-4025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26016071A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist