Provider Demographics
NPI:1871306910
Name:NSHOM, ASSURANCE
Entity type:Individual
Prefix:DR
First Name:ASSURANCE
Middle Name:
Last Name:NSHOM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1885 TARTAN LN APT 302
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-4218
Mailing Address - Country:US
Mailing Address - Phone:301-379-4273
Mailing Address - Fax:
Practice Address - Street 1:1700 E MAIN ST
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IN
Practice Address - Zip Code:46168-1849
Practice Address - Country:US
Practice Address - Phone:317-839-6822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26029562A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist