Provider Demographics
NPI:1568279313
Name:INDAAZ INC.
Entity type:Organization
Organization Name:INDAAZ INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KRISHNA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHALUVADI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-739-0311
Mailing Address - Street 1:16901 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-4434
Mailing Address - Country:US
Mailing Address - Phone:718-739-0311
Mailing Address - Fax:718-739-0999
Practice Address - Street 1:16901 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-4434
Practice Address - Country:US
Practice Address - Phone:718-739-0311
Practice Address - Fax:718-739-0999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy