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NPI Code Detail

MEDICARE: KRISHNA CHAKRAVARTHULA B.PHARMACY,MPH

MEDICARE:   KRISHNA  CHAKRAVARTHULA  B.PHARMACY,MPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist0202209068VA

General Provider Information

NPI Number : 1154620391
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISHNA CHAKRAVARTHULA B.PHARMACY,MPH
Provider Business Mailing Address
First Line : 4300 BAILEYS RIDGE DR APT 13
Second Line :
City : PRINCE GEORGE
State : VA
Zip : 23875-1467
Country : US
Telephone Number : 405-474-0934
Fax Number :
Provider Business Practice Location Address
First Line : 2305 OAKLAWN BLVD
Second Line :
City : HOPEWELL
State : VA
Zip : 23860-5032
Country : US
Telephone Number : 804-458-1231
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2011
Last Update Date : 03/25/2011

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Directions to “ KRISHNA CHAKRAVARTHULA B.PHARMACY,MPH” Practice Location

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