Healthcare Provider Details

I. General information

NPI: 1558623017
Provider Name (Legal Business Name): JAMES PHILLIP BERNAUER PHARMD, RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2012
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4141 SHORE DR
INDIANAPOLIS IN
46254-2607
US

IV. Provider business mailing address

2550 LAKE CIRCLE DR
INDIANAPOLIS IN
46268-4220
US

V. Phone/Fax

Practice location:
  • Phone: 317-329-2087
  • Fax: 317-329-2088
Mailing address:
  • Phone: 317-879-2465
  • Fax: 317-879-2466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26019018A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number26019018A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: