Provider Demographics
NPI:1205624343
Name:MADEJ, ANGELA (PHARMD)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:MADEJ
Suffix:
Gender:
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6548 SPRINGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301-8019
Mailing Address - Country:US
Mailing Address - Phone:270-925-3226
Mailing Address - Fax:
Practice Address - Street 1:6548 SPRINGWOOD DR
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-8019
Practice Address - Country:US
Practice Address - Phone:270-925-3226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26026384A183500000X
KY014251183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist