Healthcare Provider Details

I. General information

NPI: 1568138261
Provider Name (Legal Business Name): SATYA KRISHNA OGIRALA RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2021
Last Update Date: 08/22/2021
Certification Date: 08/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 ENTERPRISE ST STE 5
INDIANAPOLIS IN
46219-1106
US

IV. Provider business mailing address

14135 MURPHY CIR W
CARMEL IN
46074-1103
US

V. Phone/Fax

Practice location:
  • Phone: 800-753-0596
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number3453
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberT-100335
License Number StateMS
# 3
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26024957A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: