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NPI Code Detail

MEDICARE: BRIAUNA BRAGG PHARMD

MEDICARE: BRIAUNA BRAGG PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist26028294AIN

General Provider Information

NPI Number : 1942846522
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIAUNA BRAGG PHARMD
Provider Business Mailing Address
First Line : 904 S 19TH ST
Second Line :
City : RICHMOND
State : IN
Zip : 47374-6508
Country : US
Telephone Number : 765-969-2649
Fax Number :
Provider Business Practice Location Address
First Line : 5960 CASTLEWAY WEST DR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46250-1977
Country : US
Telephone Number : 317-579-8100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/19/2019
Last Update Date : 11/19/2019

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Directions to “ BRIAUNA BRAGG PHARMD” Practice Location

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