Healthcare Provider Details

I. General information

NPI: 1942164793
Provider Name (Legal Business Name): MYCARE RX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3141 E THOMPSON RD STE 100
INDIANAPOLIS IN
46227-6648
US

IV. Provider business mailing address

3141 E THOMPSON RD STE 100
INDIANAPOLIS IN
46227-6648
US

V. Phone/Fax

Practice location:
  • Phone: 317-442-5711
  • Fax:
Mailing address:
  • Phone: 317-442-5711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ADENIKE ADEBOMOJO
Title or Position: PIC
Credential: DR.
Phone: 317-442-5711