Healthcare Provider Details

I. General information

NPI: 1508179433
Provider Name (Legal Business Name): RAMA KRISHNA TALLURI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2010
Last Update Date: 08/03/2025
Certification Date: 08/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

760 MILES RD
WEST CHESTER PA
19380-1950
US

IV. Provider business mailing address

760 MILES RD
WEST CHESTER PA
19380-1950
US

V. Phone/Fax

Practice location:
  • Phone: 610-429-3477
  • Fax:
Mailing address:
  • Phone: 610-429-3477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP438917
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: