Nicole Anne Magsambol Apa
Individual provider Active NPI Pharmacist · Beech Grove, IN
NPI 1104601186 · NPPES record last updated Aug 29, 2023
Key facts
- NPI
- 1104601186
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 26030481A (IN)
- Practice address
- 1808 Albany St
Beech Grove, IN 46107-1404 - Phone
- (317) 786-1031
- NPI assigned
- Aug 29, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26030481A | IN | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 26030481A | IN | Yes |
Addresses
Primary practice location
1808 Albany St
Beech Grove, IN 46107-1404
Mailing address
1808 Albany St
Beech Grove, IN 46107-1404
Phone (317) 786-1031
Other providers in Beech Grove, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 29, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.