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General NPI Number Information
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NPI Number | 1245965003
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Entity Type | Organization
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Legal Business Name | RADIANT PHARMACY SOLUTIONS LLC
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Dates
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Enumeration Date | 07/17/2022
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Last Update Date | 07/17/2022
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Provider Practice Location Address
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Address Line | 1200 BATTLEFIELD BLVD N STE 103
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City | CHESAPEAKE
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State | VA
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Zip | 23320-4790
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Country | US
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Telephone | 757-734-7110
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Fax |
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Provider Business Mailing Address
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Address Line | 2201 RAYBURN LN
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City | VIRGINIA BEACH
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State | VA
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Zip | 23453-2879
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Country | US
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Telephone | 757-734-7110
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DILEEP KUMAR POTNURI
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Credential |
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Telephone | 757-734-7110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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