Provider Demographics
NPI:1306721394
Name:AZIZ, OMER (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:OMER
Middle Name:
Last Name:AZIZ
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12103 WESLEY CT
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-3049
Mailing Address - Country:US
Mailing Address - Phone:732-570-9911
Mailing Address - Fax:
Practice Address - Street 1:12103 WESLEY CT
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-3049
Practice Address - Country:US
Practice Address - Phone:732-570-9911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-08
Last Update Date:2025-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02900400183500000X
IN26031426A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist