Healthcare Provider Details

I. General information

NPI: 1982240834
Provider Name (Legal Business Name): MADELINE CLAIRE BARGA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2019
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1481 W 10TH ST
INDIANAPOLIS IN
46202-2803
US

IV. Provider business mailing address

1481 W 10TH ST
INDIANAPOLIS IN
46202-2803
US

V. Phone/Fax

Practice location:
  • Phone: 317-988-2828
  • Fax:
Mailing address:
  • Phone: 317-988-2828
  • Fax: 317-988-3334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26026895A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: