Individual
LEAH BERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
5460 E WASHINGTON ST, INDIANAPOLIS, IN 46219-6449
(317) 351-5973
(317) 351-8781
Mailing address
5460 E WASHINGTON ST, INDIANAPOLIS, IN 46219-6449
(317) 351-5973
(317) 351-8781
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26022565A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26022565A
PHARMACY LICENSE NUMBER
IN
Enumeration date
09/15/2011
Last updated
09/15/2011
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