Provider Demographics
NPI:1275129330
Name:MADINGER, KAREN SUE (RPH)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:SUE
Last Name:MADINGER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11380 HICKORY WOODS DR
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-1887
Mailing Address - Country:US
Mailing Address - Phone:317-490-5289
Mailing Address - Fax:
Practice Address - Street 1:2330 E 46TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46205-1452
Practice Address - Country:US
Practice Address - Phone:317-253-1636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-14
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INCV2005248183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist