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General NPI Number Information
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NPI Number | 1124351838
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Entity Type | Individual
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Provider Name | JOSEPH PRAVEEN TALLURI PHARM.D
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Gender | Male
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Dates
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Enumeration Date | 09/13/2009
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Last Update Date | 12/24/2022
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Provider Practice Location Address
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Address Line | 6802 W WILKINSON BLVD
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City | BELMONT
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State | NC
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Zip | 28012-6204
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Country | US
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Telephone | 704-829-5681
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Fax | 704-829-5687
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Provider Business Mailing Address
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Address Line | 368 SWEET WOODRUFF LN
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City | FORT MILL
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State | SC
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Zip | 29715-5606
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Country | US
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Telephone | 704-813-1941
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 11578
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 18697
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License Number State | NC
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