Healthcare Provider Details

I. General information

NPI: 1306637533
Provider Name (Legal Business Name): BARUPON LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2025
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26750 TOWNE CENTRE DR STE C
FOOTHILL RANCH CA
92610-2841
US

IV. Provider business mailing address

26750 TOWNE CENTRE DR STE C
FOOTHILL RANCH CA
92610-2841
US

V. Phone/Fax

Practice location:
  • Phone: 347-892-2222
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: RUPA TAMMABATTULA
Title or Position: CEO
Credential:
Phone: 347-892-2222