Nilesh V Gor, PHARMD
Individual provider Active NPI Pharmacist · Edinburgh, IN
NPI 1043866601 · NPPES record last updated Aug 9, 2019
Key facts
- NPI
- 1043866601
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 26023879A (IN)
- Practice address
- 15622 N State Road 79
Edinburgh, IN 46124-9276 - Phone
- (812) 526-2487
- NPI assigned
- Aug 9, 2019
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051.294778 | IL | MD | Pharmacist |
| 26023879A | IN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hook-Superx LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051.294778 | IL | |
| Pharmacist | 183500000X | 26023879A | IN | Yes |
Addresses
Primary practice location
15622 N State Road 79
Edinburgh, IN 46124-9276
Mailing address
15622 N State Road 79
Edinburgh, IN 46124-9276
Other providers in Edinburgh, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 9, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.