Provider Demographics
NPI:1891053047
Name:TALBERT, JANINE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:JANINE
Middle Name:
Last Name:TALBERT
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 1:9320 PRIORITY WAY WEST DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-1468
Mailing Address - Country:US
Mailing Address - Phone:800-973-1955
Mailing Address - Fax:888-361-0529
Practice Address - Street 1:9320 PRIORITY WAY WEST DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-1468
Practice Address - Country:US
Practice Address - Phone:800-973-1955
Practice Address - Fax:888-361-0529
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-25
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26020936A183500000X
KY015273183500000X
GA16789183500000X
DCPHA2679183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN26020936AOtherINDIANA BOARD OF PHARMACY