MEDICARE: DR. MANISHA PRITAM DADLANI PHARMD

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	E-14984	MS

General Provider Information

NPI Number	:	1740706423
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MANISHA PRITAM DADLANI PHARMD

Provider Business Mailing Address
First Line	:	1227 PIN OAK DR APT G4
Second Line	:
City	:	FLOWOOD
State	:	MS
Zip	:	39232-9705
Country	:	US
Telephone Number	:	662-402-1379
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 RIVER BEND PL
Second Line	:
City	:	FLOWOOD
State	:	MS
Zip	:	39232-9737
Country	:	US
Telephone Number	:	601-932-2773
Fax Number	:

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

Provider Enumeration Date	:	08/15/2017
Last Update Date	:	08/15/2017

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