MEDICARE: MRS. PADMA M KOSARAJU

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	03127699	OH

General Provider Information

NPI Number	:	1497905525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PADMA M KOSARAJU

Provider Business Mailing Address
First Line	:	25204 ROCKY HARBOUR DR
Second Line	:
City	:	PERRYSBURG
State	:	OH
Zip	:	43551-7620
Country	:	US
Telephone Number	:	419-378-2625
Fax Number	:

Provider Business Practice Location Address
First Line	:	27322 CARRONADE DR
Second Line	:
City	:	PERRYSBURG
State	:	OH
Zip	:	43551-3368
Country	:	US
Telephone Number	:	567-336-4659
Fax Number	:

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

Provider Enumeration Date	:	09/25/2008
Last Update Date	:	06/04/2026

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