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General NPI Number Information
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NPI Number | 1952920076
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Entity Type | Organization
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Legal Business Name | KUMUD S TRIPATHY AND ASSOCIATES
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Dates
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Enumeration Date | 04/09/2020
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Last Update Date | 06/07/2023
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Provider Practice Location Address
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Address Line | 2215 E VILLA MARIA RD STE 120
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City | BRYAN
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State | TX
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Zip | 77802-2585
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Country | US
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Telephone | 979-977-0193
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Fax | 979-776-0427
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Provider Business Mailing Address
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Address Line | 2215 E VILLA MARIA RD STE 120
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City | BRYAN
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State | TX
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Zip | 77802-2585
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Country | US
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Telephone | 979-977-0193
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Fax | 979-776-0427
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | RACHEL LEMMOND
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Credential | PHARM.D
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Telephone | 979-977-0193
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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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