MEDICARE: SMITHA ANIMIREDDY PHARMACIST

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
1	183500000X	Pharmacist	45869	TX

General Provider Information

NPI Number	:	1194000505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SMITHA ANIMIREDDY PHARMACIST

Provider Business Mailing Address
First Line	:	3030 GOLIAD RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78223-3959
Country	:	US
Telephone Number	:	210-359-6949
Fax Number	:	210-359-6765

Provider Business Practice Location Address
First Line	:	3030 GOLIAD RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78223-3959
Country	:	US
Telephone Number	:	210-359-6949
Fax Number	:	210-359-6765

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2011
Last Update Date	:	10/17/2011

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Directions to “ SMITHA ANIMIREDDY PHARMACIST” Practice Location

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