Provider Demographics
NPI:1992445589
Name:URBANEK, MADELINE VIRGINA (PHARMD)
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:VIRGINA
Last Name:URBANEK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:MADELINE
Other - Middle Name:VIRGINIA
Other - Last Name:SJOGREN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1620 COURTNEY AVE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40505-4021
Mailing Address - Country:US
Mailing Address - Phone:859-494-2799
Mailing Address - Fax:
Practice Address - Street 1:789 SOUTH LIMESTONE ST TODD 247
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-2404
Practice Address - Country:US
Practice Address - Phone:859-218-2003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-31
Last Update Date:2022-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY023202183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist