Leonardo Alfaro Briceno
Individual provider Active NPI Pharmacist · Indianapolis, IN
NPI 1730760950 · NPPES record last updated Apr 19, 2021
Key facts
- NPI
- 1730760950
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 26024446A (IN)
- Practice address
- 10617 E Washington St
Indianapolis, IN 46229-2611 - Phone
- (317) 895-0316
- NPI assigned
- Apr 19, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
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 |
|---|---|---|---|
| 26024446A | IN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Zenith 24, LLC | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 26024446A | IN | Yes |
Addresses
Primary practice location
10617 E Washington St
Indianapolis, IN 46229-2611
Mailing address
10617 E Washington St
Indianapolis, IN 46229-2611
Phone (317) 895-0316
Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 19, 2021. 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.