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General NPI Number Information
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NPI Number | 1407774292
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Entity Type | Individual
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Provider Name | GOVARDHANA PUNDROTHU
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Gender | Male
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Dates
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Enumeration Date | 07/08/2026
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Last Update Date | 07/08/2026
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Provider Practice Location Address
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Address Line | 155 GREAT RD
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City | ACTON
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State | MA
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Zip | 01720-5643
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Country | US
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Telephone | 351-230-0457
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Fax |
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Provider Business Mailing Address
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Address Line | 188 SOUTH RD
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City | PEPPERELL
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State | MA
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Zip | 01463-1208
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Country | US
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Telephone | 214-403-7526
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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 | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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