Healthcare Provider Details

I. General information

NPI: 1770847832
Provider Name (Legal Business Name): ASHLEY RAFLA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY N BRUTHER

II. Dates (important events)

Enumeration Date: 07/03/2012
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3480 W FRED HARRELL DR
MADISON IN
47250-6630
US

IV. Provider business mailing address

3480 W FRED HARRELL DR
MADISON IN
47250-6630
US

V. Phone/Fax

Practice location:
  • Phone: 812-599-2574
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number016072
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26025135A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: