MEDICARE: MANJUNATH MEDAHALLI KRISHNAPPA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	18634	MD

General Provider Information

NPI Number	:	1063122489
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANJUNATH MEDAHALLI KRISHNAPPA

Provider Business Mailing Address
First Line	:	2405 EASTRIDGE RD
Second Line	:
City	:	LUTHERVILLE
State	:	MD
Zip	:	21093-2509
Country	:	US
Telephone Number	:	410-790-8914
Fax Number	:

Provider Business Practice Location Address
First Line	:	75 N EAST PLZ
Second Line	:
City	:	NORTH EAST
State	:	MD
Zip	:	21901-3617
Country	:	US
Telephone Number	:	410-287-3479
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2022
Last Update Date	:	11/28/2022

Similar Medicare Providers

1477570760 — WAL-MART STORES EAST LP
Practice Location Address:

75 N EAST PLZ
NORTH EAST, MD
21901-3617

Practice Phone: 410-287-3479
Practice Fax:

1285908244 — MIKEL LAMAR HOLLEY PHARMD
Practice Location Address:

75 NORTH EAST PLAZA
NORTH EAST, MD
21901-3617

Practice Phone: 410-287-3479
Practice Fax:

1841610250 — AMANDA SLEIME PHARMD
Practice Location Address:

75 N EAST PLZ
NORTH EAST, MD
21901-3617

Practice Phone: 410-287-3479
Practice Fax:

1275153900 — LYDIA SUNYOUNG HWANG
Practice Location Address:

75 N EAST PLZ
NORTH EAST, MD
21901-3617

Practice Phone: 410-287-3479
Practice Fax:

1659343663 — DR. JOSE NIVARDO MONTANO MD
Practice Location Address:

3617 EAST M L KING JR BLVD
LYNWOOD, CA
90262

Practice Phone: 310-638-1171
Practice Fax: 310-638-3715

1639390792 — SHARON G PLACELLA MS RN CS NPP APRN BC
Practice Location Address:

554 LARKFIELD RD , SUTIE 10C
EAST NORTHPORT, NY
11731-3617

Practice Phone: 631-368-3966
Practice Fax:

Directions to “ MANJUNATH MEDAHALLI KRISHNAPPA ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.