Provider Demographics
NPI:1750263208
Name:LIGHT, MADELINE (RPH)
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:
Last Name:LIGHT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 W MIFFLIN ST UNIT 8010
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703-6009
Mailing Address - Country:US
Mailing Address - Phone:305-439-7510
Mailing Address - Fax:
Practice Address - Street 1:333 W MIFFLIN ST UNIT 8010
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-6009
Practice Address - Country:US
Practice Address - Phone:305-439-7510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21068183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist